Other examples of Clinical Record Sheets

APPENDIX 2 Example Record Sheets (may be modified or amended to suit individual requirements)
A SET OF MODEL RECORD SHEETS FOR THE MONITORING OF MICE DURING ESTABLISHMENT OF A NEW
GENETICALLY MODIFIED STRAIN
Model record sheet 1: Neonatal Assessment (Day 1 – Day 9)
Strain:
AEC Approval #:
Breeder No:
Set Up Litter Born:
Litter ID:
Room:
Investigator:
Dam ID:
Sire ID:
No:
Day 1
Day 2
Day 3
Day 4
OGTR Approval:
Animal Technician:
Born:
Born:
Day 5
Day 6
Day 7
Day 8
Day 9
Mortalities
Appearance
Size
Skin (pink to pale
colour)
Body condition
Conformation
including
deformities
Extremities (any
variation from
normal)
Behaviour
Normal wriggling
Lower than normal
wriggling
No wriggling
Responsiveness
Normal response to
touch
Low response to
touch
No response to touch
Nutrition
Good milk band
Poor milk band
No milk band
ASSESSOR’S
INITIALS
Supplementary observations and further investigations (including mothering behaviour eg nest building, pup
retrieval etc):
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Model record sheet 2: Post-weaning to adult assessment (Day 10 – Week 52)
Strain:
AEC Approval No:
Born:
ID:
Room:
Animal Technician:
Set Up:
Colour:
10
days
21
days
4
weeks
6
weeks
8
weeks
OGTR Approval No:
Breed No:
Sire ID:
12
weeks
16
weeks
20
weeks
24
weeks
28
weeks
Mortalities
Behaviour
Normal
Intensity of
activity
Lower or higher
than normal
intensity of
activity
Posture
Normal posture
Abnormal
posture (eg
hunched)
Coat condition
Smooth coat
Ruffled coat
Responsiveness
Normal
response to
touch
Low response to
touch
No response to
touch
Weight (g)
ASSESSOR’S
INITIALS
Supplementary observations and further investigations (including weaning and litter size uniformity):
D:\81922386.doc
Investigator:
Dam ID :
Born:
32
weeks
36
weeks
40
weeks
44
weeks
48
weeks
52
weeks
Model record sheet 3: Breeding performance
Strain:
Investigator:
Room:
AEC #:
Female ID:
Date
Litter ID
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Male ID:
Birth date:
Live
Born
Stillborn
Neonatal
Deaths
Neonatal
Culled
Birth date:
Weaned
F
M
Ave Wt
(g)
Set Up:
Comments
Model record sheet 4: Record sheet for scheduled monitoring and assessment of a new genetically modified
strain.
Strain
AEC Approval No
Set Up
Born
Date
Room
Investigator
Litter Born
Litter ID
OGTR Approval No.
Animal Technician
Sire ID
No. in Litter
Initials of Assessor
Date
Day 1
8 weeks
Day 2
12 weeks
Day 3
16 weeks
Day 4
20 weeks
Day 5
Week 24
Day 6
Week 28
Day 7
Week 32
Day 8
Week 36
Day 9
Week 40
Day 10
Week 44
Day 21
Week 48
Week 52
This is an example of a card that could be attached to the cage.
D:\81922386.doc
Initials of Assessor