Allegheny College Institutional Animal Care and Use Committee Protocol
Revised 3 September 2003
Instructions
INVESTIGATOR: Complete the shaded portions of this form electronically using Microsoft Word and e-mail the completed form to your Faculty Supervisor. Questions may be addressed to your Faculty Supervisor or to the Animal Research Committee (). Allow a minimum of two weeks for a judgment from the Animal Research Committee (ARC). No research upon vertebrate animals at Allegheny College is to proceed without approval of the ARC. Failure to receive ARC approval before beginning experimental manipulation is a violation of College policy, and will be reported to the College Judicial Board or Dean of Faculty. These measures are policy passed by the Allegheny College faculty; for a full statement of that policy, see the statement in the Faculty Handbook, available by request from .
FACULTY SUPERVISOR: Return any proposal that does not meet with your approval to the investigator, or indicate your approval of the research proposal by forwarding the proposal to .
Section I. General information:
Date of application: / 12/31/2000Principal Investigator: / Your name
Department: / Your department
E-mail: / Your e-mail address
Phone: / Your phone number
Faculty supervisor: / Your faculty supervisor
Title of research project: / Your project title
Protocol (select from pull-down menu): / New ProtocolRevised ProtocolRenewal
Course (dept. and number): / Your course (dept. and number)
Anticipated start date: / 12/31/2000
Anticipated completion date: / 12/31/2000
Vertebrate study species (use rows 2-4 if more than one species used) / Number used
Common name / Latin name
1.
2.
3.
4.
Section II. Experiment description:
A. Abstract: Describe in narrative form, using lay terminology, the experimental procedures and manipulations that will be performed on the vertebrate animals.
Type or paste abstract here
B. Experimental design: Describe the number of animals per experiment with a breakdown within experiments of animals per treatment condition (include number of replications and relevant controls). Explain why you chose a certain number of animals per treatment condition (taking into account known variation of the dependent variable, subject losses, etc.). Explain why you chose to use this (these) species in your research. Cost alone is not an acceptable justification for selection of the animal model.
Type or paste experimental design here
C. Chemical application: List any chemical agents apart from regular food and water that animals may come into contact with during the experiment (include anaesthetics, agents used in euthanasia, injected saline, etc). Indicate the expected effects of each agent, and also the anticipated possible effects and toxicities on experimental subjects for the short and long term. Indicate dose, volume, route, and frequency of administration.
Describe chemical application here or type N/A
D. Invasive procedures: List any surgical procedures, dissection, phlebotomy, or euthanasia that may occur during the course of the study. State method of obtaining blood or other tissues: indicate technique to be used, volume to be collected, frequency of collection and the interval between collections. Terminal blood collections require use of a suitable anesthetic.
Describe invasive procedures here or type N/A
E. Behavioral apparatus and study: List method and duration of restraint for procedures, including relevant surgeries. List apparatus used in testing, such as water mazes, skinner boxes, and modified aquaria. List procedures such as food or water deprivation, administration of noxious stimuli or substances/procedures which might induce clinical illness. Include brief descriptions of apparatus with which lay readers may be unfamiliar.
Describe procedures here or type NA
Section III. Surgical procedure:
A. Nature of any surgical procedure:
[select one from pull-down menu]
B. Description of any surgical procedure: Provide a brief description of the surgical procedure. Include relevant details from initial incision to wound closure, including administration of chemical agents. Indicate what post-surgery complications might be anticipated, and what post-operative medications might be necessary.
Describe surgical procedure here or type N/A
C. Behavioral and surgical effects: If the procedures of this experiment are expected to produce signs of clinical illness in the animals, describe those effects and explain at what point (and by what criteria) the animals may be given euthanasia. Also describe the frequency per day that the animals will be observed (and by whom) after treatment administration.
Describe behavioral and/or surgical effects here or type N/A
D. Euthanasia: If euthanasia is required to complete the study, or for humane purposes after the study, explain the procedure, explain why it is particularly appropriate for use on the species you study, and for the purpose of your study.
Explain euthanasia procedure here or type N/A
Section IV. Assessment of pain and distress:
A. Will the procedures of your studies cause animal subjects to experience momentary or slight pain or distress?
[select one from pull-down menu]
If yes, describe how discomfort and injury to the animals will be limited to that which is unavoidable in the conduct of scientifically valuable research.
Explain here or type N/A
B. Will the procedures of your studies cause animal subjects to experience more than momentary or slight pain or distress?
[select one from pull-down menu]
If yes, explain why alternatives to these procedures are not available.
Explain here or type N/A
C. Does the project involve the use of painful procedures or paralytic drugs without the benefit of anesthesics or analgesics? Select "No" or "Yes."
[select one from pull-down menu]
If yes, explain why anesthesia/analgesics are inappropriate for your experiments.
Explain here or type N/A
D. Is death (without euthanasia) an endpoint of the study?
[select one from pull-down menu]
If yes, explain why an earlier endpoint is not acceptable.
Explain here or type N/A
Section V. Animal care after the study:
A. If euthanasia is required to complete the study, explain and justify.
Explain here or type N/A
B. If euthanasia is not required, what will happen to the animals after you complete the experiment?
Explain here or type N/A
Section VI. Animal maintenance:
A. Qualifications: List name and qualifications (include education, training and experience) of individual(s) who will perform any procedures listed in sections II-III. List by procedure, including individual(s) who will monitor post-operative recovery, surgery, and euthanasia.
List and describe here
B. Housing: Building and room location(s) of animal procedure work, surgical procedure, and post-operative care:
List here or type N/A
C. Will animals stay outside of an Allegheny lab or animal colony at any time?
[select one from pull-down menu]
If Yes: Specify Location & Length of stay:
Describe here or type N/A
ARC reserves the right to inspect facilities if research animals are housed off campus.
D. Supply: Animal supplier (if known) and source of research funds:
Describe here
Section VII. Investigator's assurance:
Federal regulations hold this College responsible for the conduct of animal research on this campus and specific associated facilities. In response to this requirement, the college has established the following procedures:
A. Approval of an Institutional Animal Care and Use Committee Protocol, by the Allegheny College Animal Research Committee, is required for all vertebrate animal use. Previously approved protocols need not be renewed on an annual basis, though a call for re-approval may be issued by ARC. ARC is empowered to stop any objectionable procedures or projects. Investigators may appeal such action to the Dean of Faculty as appropriate.
B. Any significant change in personnel, species usage, animal procedures, anesthesia, post-operative care or biohazards procedures must be reported in writing as appropriate. Committee approval of the proposed changes is required prior to proceeding with the revised animal procedures under all but emergency conditions.
C. Unannounced inspections and observations of animal quarters and/or experimental procedures may be performed by the ACARC. Where procedures are causing severe distress to an animal and the pain cannot be relieved, veterinarians are authorized to humanely euthanize that animal. When possible, institutional veterinarians will always make a concerted effort to discuss such situations with investigators prior to initiating such drastic action.)
D. Investigator must ensure that the health and care of animal subjects be maintained throughout the entire course of the experiment. This includes that arrangements be made for appropriate future care of animals at the end of the experiment. Note that this applies if the investigator leaves campus (e.g., for a weekend or school break) during the course of study.
I HAVE READ THE ABOVE STATEMENTS AND AGREE TO ABIDE BY THE INSTITUTIONAL POLICIES GOVERNING USE OF VERTEBRATE ANIMALS. I FURTHER CERTIFY THAT THE PROPOSED WORK DOES NOT UNNECESSARILY DUPLICATE PREVIOUS EXPERIMENTS.
Date: / 12/31/2000Name: / Your name
NOTE: Electronic transmission of this document from your e-mail account to your Faculty Supervisor will be interpreted as submission of a signed document.