A file identified by an animal's clinical number that contains all health, surgical, and/or procedural records generated for an animal. This includes:

• Animal Treatment Report (ATR)
  • For some animals (rodents) the entirety of the permanent medical record is captured in the ATR.
  • Refer to the Animal Care Identification and Communication Procedures.
• Anesthesia or sedation monitoring forms. Refer to:
  • Guidelines on the Performance of Surgery in Non-Rodent Mammals
  • Anesthesia and Sedation Monitoring Guidelines
• Surgery report (drafted by veterinary staff for clinically-indicated surgeries)
• Post-operative records. Refer to:
  • Guidelines on the Performance of Surgery in Non-Rodent Mammals
  • Guidelines on the Performance of Surgery in Rodents
• Diagnostic test results: e.g. CBC/chemistry, urinalysis, culture and sensitivity, serology, etc.
• Radiographs
• Master problem list
• Necropsy report
• Non-human primate alopecia score sheets. Refer to:
  • Evaluation of Alopecia in Nonhuman Primates
• USDA number (dogs/cats). Refer to:
  • Procedures for Canine Quarantine and Conditioning
  • Procedures for Feline Quarantine and Conditioning
• Acquisition and disposition records (dogs/cats)

A record maintained by investigative personnel detailing the care and management (treatments, monitoring, etc.) of a health condition that is performed by the laboratory personnel under the direction of the ULAM veterinary staff.

A single record can be used for multiple animals (a group health record) if:

• All animals are being treated/monitored in the same way and for the same condition, and
• The animals are housed together in one cage and share a single clinical number.
• Components of a health/group health record include:
  • Identification of the animal(s)
  • Clinical observations/monitoring
  • Treatment information
    • Drug
    • Dose
    • Route
    • Time/frequency given
  • Date and initial all entries

A record maintained by investigative personnel that includes:

• The surgery or procedure performed
• The date performed
• Anesthetic agent administered, including route, dose, and time/frequency
• Any other drugs given (e.g. analgesics, antibiotics, reversal agents, etc.), including route, dose, and frequency
• Anesthetic monitoring parameters (e.g. temperature, pulse, respiration, blood pressure, etc.)
• Specific requirements for surgical records can be found in these ULAM documents:
  • Anesthesia and Sedation Monitoring Guidelines
  • Guidelines on the Performance of Surgery in Non-Rodent Mammals
  • Guidelines on the Performance of Surgery in Rodents

A record maintained by investigative personnel that includes:

• The surgery or procedure and the date it was performed
• Notation of (at least) daily monitoring for the duration of the post-operative monitoring period as defined in the ULAM rodent or non-rodent mammal surgical guidelines, or as described in the animal use protocol.
• Any drugs given, including the route, dose, and time/frequency.
• For animal use protocols that state analgesia will be given "as needed," personnel MUST note that an animal is not painful/no longer needs analgesics BEFORE analgesics are discontinued.
  • The presence or absence of pain MUST be noted each day for the duration of the post-operative monitoring period.
• The surgical/anesthetic/sedation record and the post-operative record may be combined and kept on a single sheet of paper if preferred.
• Specific requirements for post-operative monitoring records can be found in these ULAM documents:
  • Guidelines on the Performance of Surgery in Non-Rodent Mammals
  • Guidelines on the Performance of Surgery in Rodents

A record maintained by investigative personnel that includes:

• Daily food and/or fluid volume consumed
• Hydration status
• Appearance and general affect
• Experimental performance
• Routine body weights
• Refer to the Guidelines on Experimental Food or Water Restriction or Manipulation in Laboratory Animals

A record that may be maintained by investigative personnel that may include:

• Animal identification information
• Date and type of procedure performed/compounds administered
• Routine observations as defined by the protocol
• Adverse or unexpected consequences
• Date of euthanasia or termination of study

A cage specific record that may include:

• Information about the breeders: birth dates of breeders (dam and sire), their genotypes, identifiers such as ear tag numbers, and what generation they are in the line (particularly if backcrossing or inbreeding)
  • Correct nomenclature is strongly encouraged. Please refer to this Jackson Labs tutorial for guidance
• Information about the breeding itself: the mate date (day the male and female/s were first co-housed)
• Information about the resulting litters: birth dates of litters, number of pups born, number of pups noted to have died or become missing, and weaned, and weaning dates.
• Digital records are useful to track breeding colony success over time. This can be done in excel or using an online mouse colony tracking software. A free online breeding tracking program is SoftMouse

A record of the death, euthanasia, transfer, sale, adoption, or donation of an animal.

Health information/medical history that arrives with the animal. This is incorporated into the animal's permanent medical record.

Those records that must be maintained by investigative personnel:

• Health/group health records are required if the laboratory personnel are performing any part of the monitoring and care of a non-research-related clinical condition under the direction of the veterinary staff.
• Surgical/anesthetic/sedation records are required for all animals undergoing those procedures.
• Post-operative monitoring records are required for all animals undergoing survival surgery.
• Tumor monitoring records must be maintained as described in the animal use protocol for all animals with experimentally induced tumors
• Food and water restriction records are required for all animals undergoing such restriction as per the animal use protocol and the Guidelines on Experimental Food or Water Restriction or Manipulation in Laboratory Animals.
• Records of disposition are required for all cats and dogs.

Those records that are not mandated (unless described in the protocol). However, generating and maintaining these records is highly recommended.

• Experimentally induced disease/research records
• Breeding records

The person(s) listed as such on the animal use protocol and the cage card.

A unique identifying number assigned by ULAM personnel used to centralize information into complete medical records in a retrievable form. Clinical numbers may be assigned to an individual animal or a group of animals depending on the circumstance.

• Large animals receive an individual clinical number and is recorded on the cage card upon arrival.
• Rodents receive a clinical number assigned per cage if a clinical concern is reported to the veterinary personnel.
  • ##### is a unique identifier for that animal
• The format for all species is CLN########.

Those involving animals currently being treated and/or monitored for a clinical condition, or an experimental condition (e.g. tumor burden, food and water restriction, etc).

Those involving animals that are no longer being treated and/or monitored. Cases become inactive when:

• A clinical condition is resolved by the veterinary staff.
• The animal is euthanized or un-enrolled from study.
• The animal is transferred to another laboratory or institution.

The sale, transfer, donation, adoption, death, or euthanasia of an animal.