This is the html version of the file http://www.nmsu.edu/Research/docs/iacuc.doc. Use word version for submittal

APPLICATION FOR PERMISSION TO USE ANIMALS IN RESEARCH AND TEACHING

NEW MEXICO STATE UNIVERSITY

 DO NOT LEAVE  BLANKS. 

Investigator/Instructor:     Dept.:     Tel.:  

FACULTY/PROFESSIONAL STAFF (Only if Investigator/Instructor is a student): 

Title of Research Project/Course: 

Animal Use is for: Research  Teaching  Agriculture  Other (Specify) ______________ 

Application is: New Renewal  Continuation  Supplement  Revision  

              Pilot Project   

Funding Source:  
 

Duration of Project/Course:   to     

Research/Course involves vertebrate animals (yes, no)          Species: ______________________ 
 

Name, position, education, and years experience with this species of each person who will perform the experimental/instructional manipulations on the animal(s) and(or) be involved in the care, use and treatment of the animal(s) (includes teaching assistants, graduate students, etc.). 
 

Does this person have a certificate in Animal Welfare Training?

If no, please explain 
 

This project will involve Category (A,B,C,D,E — see attached page):  

Rationale for using animals and the appropriateness of this SPECIFIC SPECIES and NUMBER in this project:  
 

Drugs will be used in this Research Project/Course (yes, no).  If yes, provide names, dosages, and routes of administration 
 

Provide a brief Description of the Purpose and Experimental Procedures used in this Project/Course:  
 

Provide the name and telephone number of the veterinary consultant utilized for this program. 
 

Describe actions taken, including literature search to seek valid alternatives and avoid unnecessary duplication for the proposed research.  Include names of databases searched and key words utilized. 
 
 
 
 
 
 

Information on Animals used in THIS Research/Course: 

Total Number of Animals to be used:  

Animal Supplier:  

Animal housing location: 

Method of Euthanasia:

Disposition of Dead/Live Animal 
 

FACULTY/PROFESSIONAL STAFF ASSURANCE STATEMENT 

I accept and will conform to all Federal and State Laws and guidelines and all institutional policies and procedures concerning the care and use of vertebrate animals. I understand that I have a responsibility to notify in writing the Institutional Animal Care and Use Committee of any substantive changes in the proposed project or personnel, relative to this application, PRIOR to proceeding with any animal use. 

                                                                                                          

Faculty/Professional Staff  __________________________________________       Date     

      

Dept. Head                       ___________________________________________       Date _____________________ 

Dean, Director, or Research Leader ___________________________________       Date _____________________                                                                         
 

              INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE 

                     APPROVED/DISAPPROVED

                                          

              IACUC Chair  ____________________________________ 

                     Date  ____________________________________ 

Send the original signed form to:  Dr. Dennis Hallford, IACUC Chair, Box 3I.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          

             Also email the form as a word or word perfect attachment to dhallfor@nmsu.edu 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Form Revised January 26, 2003 
 
 
 

 

TABLE 1 

CATEGORIES OF BIOMEDICAL EXPERIMENTS

BASED ON INCREASING ETHICAL CONCERNS FOR NON-HUMAN SPECIES

 

CATEGORY A

 

Experiments involving either no living materials or use of plants, bacteria, protozoa, or invertebrate animal species. 

Biochemical, botanical, bacteriological, microbiological, or invertebrate animal studies, tissue cultures, studies on tissues obtained from autopsy or from slaughterhouses, or studies on embryonated eggs.  Invertebrate animals have nervous systems and respond to noxious stimuli, and therefore must also be treated humanely.

CATEGCATEGORY B

 
 

Experiments on vertebrate animal species that are expected to produce little or no discomfort. 

Mere holding of animals captive for experimental purposes; simple procedures such as injections of relatively harmless substances and blood sampling; physical examinations; experiments on completely anesthetized animals which do not regain consciousness; food/water deprivation for short periods (a few hours); standard methods of euthanasia that induce rapid unconsciousness, such as anesthetic overdose or decapitation preceded by sedation or light anesthesia. 

CATEGCATEGORY C

 
 

Experiments that involve some minor stress or pain (short-duration pain) to vertebrate animal species. 

With anesthesia, exposure of blood vessels or implantation of chronic catheters; behavioral experiments on awake animals that involve short-term stressful restrain; immunization employing Freund’s Adjuvant; noxious stimuli from which escape is possible surgical procedures under anesthesia that may result in some minor post-surgical discomfort.  Category C procedures incur additional concern in proportion to the degree and duration of unavoidable stress or discomfort. 

CATEGCATEGORY D

 
 

Experiments that involve significant but unavoidable stress or pain to vertebrate animal species. 

Deliberate induction of behavioral stress in order to test its effect; major surgical procedures under anesthesia that result in significant post-operative discomfort; induction of an anatomical or physiological deficit that will result in pain or distress; application of noxious stimuli from which escape is impossible; prolonged periods (up to several hours or more) or physical restraint; maternal deprivation with substitution of punitive surrogates; induction of aggressive behavior leading to self-mutilation or intra-species aggression; procedures that produce pain in which anesthetics are not used, such as toxicity testing with death as an end point, production of radiation sickness, certain injections, and stress and shock research that would result in pain approaching the pain tolerance threshold, i.e. the point at which intense emotional reactions occur.  Category D experiments present an explicit responsibility on the investigator to explore alternative designs to ensure that animal distress is minimized or eliminated. 

CATEGORY E

 
 

Procedures that involve inflicting severe pain near, at, or above the pain tolerance threshold of unanesthetized, conscious animals. 

Use of muscle relaxants or paralytic drugs such as succinyl choline or other curariform drugs used alone for surgical restrain without the use of anesthetics; severe burn or trauma infliction on unanesthetized animals; attempts to induce psychotic-like behavior; killing by use of microwave ovens designed for domestic kitchens or by strychnine; inescapably severe stress or terminal stress.  Category E experiments are considered highly questionable or unacceptable irrespective of the significance of anticipated results.  Many of these procedures are specifically prohibited in national policies and therefore may result in withdrawal of federal funds and/or institutional USDA registration.