ESSENTIALS FOR ANIMAL RESEARCH:
A PRIMER FOR RESEARCH PERSONNEL
Second Edition, B. T. Bennett, M. J. Brown and J. C. Schofield
United States Department of Agriculture
National Agricultural Library
Beltsville, Maryland
Revised October 1994
INTRODUCTION
This manual was developed from the outlines of a course entitled
Essentials for Animal Research, originally developed at the University of
Illinois at Chicago for graduate students who wanted to learn more about
the use of animals in research than generally covered in the training
received in their chosen area of concentration. From its inception, the
course has constantly evolved to remain current with ever-changing
regulations and an increasing awareness by graduate students of the issues
concerning the use of animals in biomedical research, teaching and
testing. The course introduces those elements which have become essential
requirements for using animals in research, teaching or testing programs.
These requirements primarily center around the responsibilities one
assumes when they intend to use animals in their work. The ultimate
responsibility lies with the Principle Investigator who must have a
working knowledge of the regulations, be familiar with the factors that
affect the selection, acquisition and maintenance of experimental animals
and be aware of the ethical and social issues involved with the use of
animals in biomedical research.
The goals and objectives established for developing the class lectures
are applicable to the material presented in this manual. With these goals
in mind, the authors developed the ten chapters included in this manual.
Remember it was not the authors' intentions to present an exhaustive
treatise on key elements essential for conducting animal research in a
manner which assures individual and institutional compliance with
pertinent regulatory requirements, but rather an introduction to the
subject matter in a manner which will hopefully encourage additional
reading where appropriate.
In writing this manual it was the author's intent to provide the reader
with:
1. An appreciation and basic understanding of the regulatory process and
the means by which compliance can be assured. An overview of those factors
which can affect the selection, acquisition and maintenance of animals
used in biomedical research.
2. An understanding of the basic principles of controlling pain and
distress, preventing intraoperative infection and assuring a humane death
in the animals used.
3. An awareness of the responsibilities that one assumes when choosing
to use laboratory animals. These responsibilities would include, but not
be limited to, those which involve an obligation to the institution,
regulatory and funding agencies, the public and the animals.
The manual has been organized into ten chapters, the first seven are
intended to cover the specific objectives described above. The last three
chapters contain resource information on the Animal Welfare Information
Center of the National Agricultural Library, a list of organizations from
which additional information can be obtained and a list of general
references covering topics of interest to the investigator who utilizes
animals in research, teaching and testing programs.
The second edition of this manual has been updated to reflect recent
changes in the regulations, the report of the 1993 AVMA Panel on
Euthanasia and the expanded resources and services of the Animal Welfare
Information Center.
The authors would like to thank Drs. James Harwell, Louis Ramazzotto
and Richard Simmonds for their input and support during the review process
of this project and Ms. Lisa Halliday and Ms. Doris Thomas for their
assistance in preparing the second edition. To the staff of the AWIC, we
send our appreciation for their enthusiastic support throughout the
project and for their assistance in the final stages of transferring the
electronic version of the manual to the library.
This manual was produced as joint effort of the USDA National Library
of Agriculture and the University of Illinois at Chicago and supported by
cooperative agreement number 58-32U4-7-070.
Chapter 1: Regulations and Requirements
B. Taylor Bennett, D.V.M., Ph.D.
INTRODUCTION
Since the ultimate responsibility for compliance with regulations that
affect the care and use of animals lies with the investigator, it is
important that he/she have a working knowledge of the basic regulatory
requirements. In this manual, the types of regulations will be discussed
under two broad general headings:
1. Involuntary
2. Voluntary
Involuntary regulations can be defined as those required by law or set
forth as a condition of funding. There are four types of regulatory
controls which can be considered as involuntary:
1. The Animal Welfare Act (AWA)
2. The Public Health Service Policy
3. The Good Laboratory Practices Act
4. The Requirements of Private Funding Agencies
Voluntary regulations can be defined as those that an individual or
institution adheres to as part of their overall commitment to research and
academic excellence. There are two types of regulatory controls which can
be considered as voluntary:
1. Accreditation by the American Association for Accreditation of
Laboratory Animal Care (AAALAC)
2. Requirements of Individual Users
INVOLUNTARY REGULATIONS
Animal Welfare Act
The Animal Welfare Act was first passed August 24, 1966, as PL-89-544.
It was entitled the "Laboratory Animal Welfare Act" and authorized, "The
Secretary of Agriculture to promulgate such rules and regulations, and
orders as he may deem necessary to effectuate the purposes of this Act."
The purposes of the original act were to:
1. Protect the owners of dogs and cats from theft of such pets.
2. Prevent the sale or use of dogs and cats which had been stolen.
3. Insure that certain animals intended for use in research facilities
were provided humane care and treatment.
In charging the Secretary, Congress specifically prohibited the
promulgation of rules, regulations, or orders which would interfere with
the conduct of actual research. Determination of what constituted actual
research was left to the discretion of the research facility.
The original Act covered non-human primates, guinea pigs, hamsters,
rabbits, dogs and cats. Humane treatment was required while they were at
the dealers or research facility and while being transported by dealers.
Dealers were required to be licensed. Research facilities which used, or
intended to use, dogs or cats and either purchased them in commerce or
received any federal funds were required to be registered.
The Secretary also established regulations and standards for the
implementation of unannounced facility inspections and for the maintenance
of specific records by dealers and research institutions. Responsibility
for administering the Act was delegated within the United States
Department of Agriculture (USDA) to the Administrator of the Animal and
Plant Health Inspection Service (APHIS). Enforcement duties are the
responsibility of the APHIS Deputy Administrator for Regulatory
Enforcement and Animal Care (REAC). The actual inspections are conducted
by 46 Veterinary Medical Officers working under one of the four REAC
Sector Supervisors. The Sector offices are located in Fort Worth, Texas,
Tampa, Florida, Annapolis, Maryland, and Sacramento, California.
In 1970 the original Act was amended (PL-91-579) and renamed the Animal
Welfare Act. The amended Act covered broader classes of animals and
included those used in exhibitions and sold at auction and regulated
anyone involved in these activities. The definition of an animal was
expanded to include all warm-blooded animals. The definition of a research
facility was expanded to include those institutions using covered live
animals and not just dogs and cats. These facilities were required to file
an annual report. Civil penalties were also added for refusing to obey a
valid cease and desist order from the Secretary. The term "handling" was
added to the basic categories for which standards were to be created and
the phrase "adequate veterinary care" was broadened to include the
appropriate use of anesthetics, analgesics and tranquilizers.
The intent of the original Act to prohibit interference with research
was clarified and the Secretary was enjoined from directly or indirectly
interfering with, or harassing in any manner, research facilities during
the conduct of actual research or experimentation. The determination of
when actual research was being done was still left to the discretion of
the research facility itself.
In 1976, the Animal Welfare Act was further amended to enlarge and
redefine the regulation of animals during transportation and to combat the
use of animals for fighting. Essentially the Act was broadened to include
all forms of commercial transportation of animals and required all
carriers and intermediate handlers who were not required to be licensed
under the Act to register with the USDA. It also expanded the definition
of a dealer and extended the record keeping requirements to carriers and
intermediate handlers.
In 1976, the Secretary also promulgated regulations which specifically
excluded rats, mice, birds, horses and farm animals from the definition of
an animal. This exclusionary language effectively excludes over 80 percent
of the animals currently used in research, teaching and testing from
coverage under the Animal Welfare Act.
In 1985 the Act was further amended with the passage of the Food
Security Act of 1985 (PL-99-198) which contained an amendment entitled the
"Improved Standards for Laboratory Animals Act." This amendment
strengthened the standards for providing laboratory animal care, increased
enforcement of the Act, provided for collection and dissemination of
information to reduce unintended duplication of experiments using animals
and mandated training for those who handle animals.
The 1985 amendment to the AWA also included development of standards:
for the "exercise of dogs," for "provision of a physical environment which
promotes the psychological well-being of primates," for limitation of
multiple survival surgeries, and to require the investigator to consult
with a veterinarian in the design of experiments which have the potential
for causing pain to insure the proper use of anesthetics, analgesics and
tranquilizers. Each research facility has to show upon inspection, and
include in their annual report, assurances that professionally acceptable
standards for the care, treatment and use of animals are being used during
the actual research or experimentation. As part of these standards, the
investigator is required to consider alternative techniques to those which
might cause pain or distress in the experimental animals.
The 1985 amendment required the Chief Executive Officer of each
research facility to appoint an Institutional Animal Committee consisting
of at least three members including a doctor of veterinary medicine and
one member who is not affiliated with the institution. The regulations
promulgated to implement the amendment designated this committee as the
Institutional Animal Care and Use Committee (IACUC) and charged it to act
as an agent of the research facility in assuring compliance with the Act.
The Committee is required to inspect all animal facilities and study areas
at least once every six months, and to review the condition of the animals
and the practices involving pain to the animals to insure compliance with
the regulations and standards promulgated under the Act. The Committee is
also required to review once every six months the research facility's
program to assure that the care and use of the animals conforms with the
regulations and standards. The Committee must file a report of its
inspection with the Institutional official of the research facility. If
significant deficiencies or deviations are not corrected in accordance
with the specific plan approved by the Committee, the USDA and any Federal
funding agencies must be notified in writing.
The Committee must also review and approve all proposed activities
involving the care and use of animals in research, testing or teaching
procedures and all subsequent significant changes of ongoing activities.
As part of this review, the Committee must evaluate procedures which
minimize discomfort, distress and pain and that when an activity is likely
to cause pain that a veterinarian has been consulted in planning for the
administration of anesthetics, analgesics and tranquilizers and that
paralytic agents are not employed except in the anesthetized animal. The
IACUC must also determine that animals which experience severe or chronic
pain are euthanatized consistent with the design of study, that the living
conditions meet the species needs, that necessary medical care will be
provided, that all procedures will be performed by qualified individuals,
that survival surgery will be performed aseptically and that no animal
will undergo more than one operative procedure that is not justified and
approved. Methods of euthanasia must be consistent with the definition
contained in the regulations.
The IACUC must also assure on behalf of the research facility that the
principal investigator considered alternatives to painful procedures and
that the work being proposed does not unnecessarily duplicate previous
experiments. To provide assurance of the former the Committee must review
the written narrative description provided by the investigator. This
description must include the methods and sources used in determining that
alternatives were not available. In reviewing proposed activities and
modifications, the IACUC can grant exceptions to the regulations and
standards, if they have been justified in writing by the principal
investigator.
In addition to the above requirements, the research facility is
required to provide training in the following areas to scientists, animal
technicians and other personnel involved with animal care and treatment:
1. Humane practice of animal maintenance and experimentation.
2. Research or testing methods that minimize or eliminate the use of
animals or limit pain or distress.
3. Utilization of the information service of the National Agricultural
Library.
4. Methods whereby deficiencies in animal care and treatment should be re-
ported.
The regulations require that each research facility establish a program
of adequate veterinary care that includes: appropriate facilities,
personnel and equipment; methods to control, diagnose and treat diseases;
daily observation and provision of care; guidance to personnel on the use
of anesthetic, analgesic and euthanasia procedures and pre- and
post-procedural care. Specific requirements for maintaining records and
filing annual reports are included in the regulations along with a
miscellaneous section containing a variety of requirements to which a
research facility must adhere.
The most recent amendment to the AWA (PL 101-624) was passed in 1990
and was entitled the Pet Protection Act. The regulations developed to
implement this amendment define the minimal holding period for animals in
pounds and shelters that are sold to dealers, and establish record keeping
requirements for dealers who obtain dogs or cats from these sources.
Public Health Service Policy
The Public Health Service Policy on Humane Care and Use of Laboratory
Animals can be found in Chapter 4206 of the NIH Manual and Chapter 1-43 of
the PHS Manual. The NIH originally initiated the Policy in 1971. It was
extended to all PHS activities January 1, 1979, and was revised in the
spring of 1985 with implementation to be effective January 1, 1986. With
the passage of the Health Re- search Extension Act of 1985 (PL-99-158),
the Policy was further revised and the Director of the NIH was required by
law to establish guidelines which heretofore had only been a matter of PHS
policy. An additional revision was released in September 1986 which
reflected the changes required by this Act.
Under the PHS policy, each institution using animals in PHS-sponsored
projects must provide acceptable written assurance of its compliance with
the Policy. In this Letter of Assurance the institutions must describe:
1. The Institutional Program for the Care and Use of Animals.
2. The Institutional Status.
3. The Institutional Animal Care and Use Committee (IACUC).
The Institutional Program must include a list of every branch
and major component, the lines of authority for administering the program;
the qualifications, authority and responsibility of the veterinarian(s),
the membership of the Institutional Animal Care and Use Committee and the
procedures which they follow must be stated. The employee health program
must be described for those who have frequent animal contact. A training
or instruction program in the humane practices of animal care and use must
be available to scientists, animal technicians and other personnel
involved in animal care, treatment and use. The gross square footage,
average daily census and annual usage of each animal facility must be
listed.
The Institutional Status must be stated as either Category one (1)
(AAALAC accredited) or Category two (2) (non-accredited). Institutions in
Category two (2) must establish a reasonable plan with a specific
timetable for correcting any departures from the recommendations in the
Guide for the Care and Use of Laboratory Animals (86-23).
The IACUC must be appointed by the Chief Executive Officer and
consist of at least five members; one of whom is a veterinarian with
program responsibility, a practicing scientist, an individual whose
expertise is in a non-biological science and an individual who is not
affiliated with the institution. This Committee must use the Guide
to review the animal facilities and the institutional program for humane
care and use of animals at least once every six months and prepare reports
of these evaluations for the responsible institutional official. The
Committee must review and approve animal-related components of proposals
and significant modifications made in ongoing activities involving the
care and use of animals. The Committee is responsible for reviewing
concerns involving the care and use of animals and making recommendations
to the institutional official regarding any aspect of the animal program,
the facilities, or the personnel training. They are also authorized to
suspend activity involving the care and use of animals as set forth in the
PHS Policy.
In reviewing the animal care and use component of a proposal, the IACUC
must confirm that the project will be conducted in accordance with the AWA
and consistent with the recommendations in the Guide. In addition,
all procedures are reviewed to assure that pain or distress will be
minimized and that (when necessary) appropriate anesthetics, analgesics
and tranquilizers will be used. The living conditions and medical care
available must be appropriate for the species used, and personnel
conducting the procedures must be appropriately trained and qualified.
Methods of euthanasia should be consistent with the recommendations of the
American Veterinary Medical Association Panel on Euthanasia.
The investigator is responsible for completing a proposal in accordance
with recommendations in the PHS Policy and the instructions contained in
the PHS 398 application packet. As of September 1991, the instructions for
completing 398 can be found in two locations within the application
package. On page 13 the research investigator's responsibilities for
assuring compliance with the PHS Policy are clearly addressed. Detailed
instructions for completing Section 6 of the Research Plan which describes
the use of Vertebrate Animals can be found on page 23.
The institution is responsible for maintaining all the necessary
records to document compliance with the PHS Policy and for filing annual
reports developed by the IACUC which detail any changes in the program and
indicate the dates of the semi-annual inspections and programmatic
reviews.
The PHS Policy described above is intended to implement and supplement
the "U.S. Government Principles for the Utilization and Care of Vertebrate
Animals in Testing, Research and Training." The nine principles are
published in the PHS Policy and in the Appendix of the Guide. All
those responsible for the design, supervision and review of the animal
care and use component of a proposal should be familiar with this
document.
Good Laboratory Practices
In 1978 the Food and Drug Administration adopted the Good Laboratory
Practices rules which applied to all regulated parties who conduct
non-clinical safety assessment studies. The rules require the creation of
Standard Operating Procedures for all aspects of the study including
animal care and use. A Quality Assurance Unit must be established to
conduct internal inspection of practices and records to insure compliance
with established policies and procedures. In general the recommendations
contained in the Guide would suffice in terms of animal care when
adherence is properly documented.
Private Funding Agencies
In recent years the requirements of many private funding agencies which
fund research projects involving the care and use of laboratory animals
have changed. It is important to obtain the requirements from the agency
before spending time preparing a proposal. Some of these agencies not only
require review of the proposal by the IACUC, but require proof of
accreditation by AAALAC. In many in- stances, the proposals must be
reviewed and approved prior to submission.
VOLUNTARY
American Association for Accreditation of Laboratory Animal Care (AAALAC)
AAALAC was originally chartered April 30, 1965, as a voluntary
organization that accredited institutional programs of animal care and
use. AAALAC is governed by a Board of Trustees composed of representatives
of 39 professional organizations. An 18-member Board-appointed Council on
Accreditation along with four scientific/technical panelist make
recommendations based on the results of site visits to evaluate an
institution's compliance with the recommendations contained in the
Guide. This is a peer review process in which standards are being
continually upgraded to reflect current knowledge in laboratory animal
medicine and science. In its accreditation program the AAALAC Council uses
the Guide more as a compilation of regulatory "standards" and not
as a set of "recommendations." Since the AAALAC accreditation program and
the Guide are so closely linked, a brief review of the Guide's
history and its current contents are warranted. In 1963 the first Guide
for Laboratory Animal Facilities and Care was published by the
Institute for Laboratory Animal Resources (ILAR) under a contract from NIH.
Since its original release the Guide has been revised in 1965,
1968, 1972 (when the title was changed to the Guide for the Care
and Use of Laboratory Animals) 1978 and 1985. In the most recent revision,
the organization of the chapters was changed to reflect the increasing
role and responsibility of the institutional program in establishing
acceptable standards for the care and use of laboratory animals. The first
chapter is now Institutional Policies. The remaining four chapters are
Laboratory Animal Husbandry, Veterinary Care, Physical Plant and Special
Considerations.
Prior to an AAALAC site visit, each institution is required to prepare
a description of the institutional facilities and programs using the
AAALAC Outline for Description of The Institutional Animal Care and Use
Program, which follows the Guide's chapter headings.
Once accredited, an institution must submit an annual report describing
changes in the program and facilities and documenting the annual usage of
animals. Site visits occur at least every three years and these visits
consist of an inspection and review of policies, procedures and facilities
which comprise the animal care and use program inclusive of selected
animal usage areas. Should deficiencies be identified in a previously
accredited program, the institution is either granted a defined period in
which to make specified changes, or if the deficiencies are major,
accreditation could be withdrawn.
Individual Users
The instructions for completing PHS 398 clearly define the roles and
responsibilities of the investigator in assuring proper care and usage of
laboratory animals. In addition to this requirement, it should be
understood that any type of care or use of an animal which results in the
creation of non-experimental variables can potentially compromise the
integrity of an entire project. As part of their commitment to scientific
excellence, the users should provide the impetus for setting and
maintaining high standards for the care and use of laboratory animals
within their individual and collective institutions. Failure to do so
invites increased internal and external regulatory requirements which can
drain limited institutional research resources. Good animal care is good
science; the practice of good science should be the primary goal of all
who have chosen careers in the scientific community.
SUMMARY
In summary, the regulations that affect the use of animals in research,
teaching and testing programs are numerous. A working knowledge of the
applicable regulations is necessary if the principal investigator is to
insure that proposals for funding contain the necessary information and to
assure that the conduct of all research proposals is in compliance with
the requirements of the regulatory and funding agencies. While the
ultimate responsibility for compliance rests with the principal
investigator, institutional policies should be designed to provide those
responsible for compliance with the necessary resources to do so.
REFERENCES
Application for Public Health Service Grant, PHS, 398. Revised
September, 1991. OMB No. 0925-001.
Animal Welfare Act (Title 7 U.S.C. 2131-2156), as amended by PL-99-198,
December 12, 1986.
Guide for the Care and Use of Laboratory Animals, NIH Publication
No. 86-23.
Public Health Service Policy on Humane Care and Use of Laboratory
Animals. Revised as of September 1986.
Non-Clinical Laboratory Studies. Good Laboratory Practice Regulations.
Register, December 22, 1978, Part II, pp. 59986-60026.
Public Law 99-198. Code of Federal Regulations, Title 9, subchapter A,
Animal Welfare 1989.
Townes, J. Federal Regulations an Overview, Lab Animal, July-August
1980; 9:4 l6-22.
Chapter 2
Alternative Methodologies
B. Taylor Bennett, D.V.M., Ph.D.
INTRODUCTION
In the regulations promulgated to implement the Animal Welfare Act as
amended in 1985, the research facility must provide assurances that the
principal investigators considered alternatives techniques to painful
procedures and provide guidance concerning research and testing methods
that limit the use of animals or minimize the animals' distress. In this
chapter the reader will be introduced to the classical concept of
alternatives with a brief discussion of each major category including a
limited number of examples. For more indepth coverage of the subject, the
reader is encouraged to obtain the latest bibliography on alternative
techniques available from the Animal Welfare Information Center of the
National Agricultural Library (see Chapter 8).
In recent years the term alternative techniques has come into
common usage in the current controversy involving the use of animals in
research, teaching and testing. It is a term that has different meanings
to different people and this difference largely depends on which side of
the issue one is found. To many biomedical researchers, alternative
techniques refer to those which can be used in addition to the more
traditional animal models. These techniques can focus on specific
biological functions and in many cases reduce the numbers of animals used.
Therefore these methods are an adjunct to the more commonly used animal
models. To the so-called abolitionist who seeks the immediate end to all
animal research, teaching and testing, the term alternative refers
to those techniques which can entirely replace the use of animals. The
dictionary, defines alternative as: "offering or expressing a
choice." The dictionary also defines technique as "a method of
accomplishing a desired aim." By combining these definitions, the term
alternative technique becomes "one which offers a choice in
accomplishing a desired aim."
In designing an experiment which involves the use of animals to confirm
or refute a theory, one should consider all the possible techniques that
could be used to gather the necessary data. From this review, choose the
method which offers the best chance of generating the necessary
information in the most economical manner. Economy, in this context,
refers to time, actual cost and the number of animals used. By considering
the choices that are available for accomplishing the desired aim of the
experiment and choosing the one that offers the best chance for success,
one has met the requirements of this literal definition of alternative
techniques.
Since a literal definition provides a rather simplistic approach to
dealing with our responsibility for reducing the potential pain and
suffering of animals that must be used, it is necessary to develop a
working definition of the term. In Dr. Rowan's book, Of Mice, Models &
Men, he defines the term alternatives to refer to those techniques or
methods that "replace the use of laboratory animals altogether, reduce the
numbers of animals required, or refine an existing procedure or technique
so as to minimize the level of stress endured by the animal." Since stress
can be difficult to describe and quantify, for the purpose of this
manual it will be replaced by the term distress. The working
definition of alternative techniques thus evolves to "those techniques
which replace the actual use of animals, reduce the numbers used, and/or
refine the techniques to minimize the potential for the animal to
experience pain or distress."
This concept of the 3 R's is not new. It first appeared in a book by
Russell and Burch published in 1959 entitled The Principles of Humane
Experimental Technique. In the original work, the authors defined the
3 R's as follows:
"Replacement means the substitution for conscious living higher animals
of insentient material. Reduction means reduction in the numbers of
animals used to obtain information of given amount and precision.
Refinement means any decrease in the incidence or severity of inhumane
procedures applied to those animals which still have to be used."
In this text the authors included non-recovery techniques in
anesthetized animals, as well as tissue culture, as replacement methods.
Reduction included statistical techniques which were designed to reduce
the actual numbers needed in the study. The use of better animals was also
encouraged as a means of reducing actual numbers used. Refinement referred
to techniques that reduced the potential for pain and distress. This
approach still holds today. It is the principles of Replacement, Reduction
and Refinement that will be covered in this chapter. To attempt to address
these issues for all the uses of animals that fall under the general
rubric of research, teaching and testing is far beyond the scope of this
manual. Therefore the comments that follow will address only broad issues
with some specific examples for the purpose of clarification.
Prior to discussing the replacement of animals with non-animal models,
the word animal must be defined. On the surface this appears an
easy task. Common sense would tell us that an animal is one of the two
major kingdoms of living organisms. The dictionary defines an animal as
"any of a kingdom of living beings typically differing from plants in
capacity for spontaneous movement and rapid motor response to
stimulation." In the Definition of Terms promulgated to implement the
amended Animal Welfare Act an animal is defined as:
"any live or dead dog, cat, nonhuman primate, guinea pig, hamster,
rabbit, or any other warm blooded animal, which is being used or is
intended for use for research, testing, experimentation, or exhibition
purposes or as a pet. This term excludes: Birds, rats of the genus Rattus
and mice of genus Mus bred for use in research, and horses and other farm
animals such as but not limited to livestock or poultry used or intended
for use as food or fiber, or livestock, or poultry used or intended for
use for improving animal nutrition, breeding, management, or production
efficiency, or for improving the quality of food and fiber."
The PHS Policy defines an animal as "Any live, vertebrate animal used
or intended for use in research, research training, experimentation, or
biological testing or for related purposes." On the other hand the
Guide defines an animal as "any warm blooded vertebrate animal." For
the purposes of this manual, and to be consistent with most approaches to
discussing alternative techniques, an animal will be any living
vertebrate, with the caveat that any model system which moves down the
phylogenic scale from the generally acceptable animal model will be
considered an alternative.
REPLACEMENT
Alternatives which replace animal models can be classified into the
following broad general categories:
Use of Living Systems
Use of Nonliving Systems
Use of Computer Simulation
Use of Living Systems
In Vitro Techniques - The most commonly recognized
non-animal living systems are those which fall into the broad category of
in vitro methods such as organ, tissue and cell culture. These
techniques afford the investigator the greatest control of the "test
subject's" environment. Since these systems will not work when the
incorrect combination of atmosphere, humidity, temperature, pH and
nutrients are provided, they tend to minimize the effects that
non-experimental variables can have on the final outcome of a study.
Generally, when suboptimal environments are provided for an in vitro
system, the problem becomes one of loss of all experimental results and
not just the production of compromised results. The most commonly used of
the in vitro methods are cell culture techniques for monoclonal
antibody production, virus vaccine production, vaccine potency testing,
screening for the cytopathic effects of various compounds and studying the
function and make up of cell membranes. The potential uses of in vitro
techniques are almost limitless and will continue to expand as more is
learned about the various organs and their component tissues and cells,
and as the technology of maintaining in vitro environments
improves.
Invertebrate Animals - Invertebrates are another type of
living system which can be used to replace the more commonly used
laboratory animals. Over 90 percent of the animal species thus far
identified are invertebrates. An invertebrate which has long been used in
biomedical research is the fruit fly, Drosophila melanogaster -- a
classic model for the study of genetics. This species also can be used for
detecting mutagenicity, teratogenicity and reproductive toxicity. The
marine invertebrates represent different species which have not been
widely investigated. However in neurobiology a number of different marine
species have been well characterized and used to study the physiology of
the nervous system.
Micro-Organisms - The micro-organisms represent a third
system which has been used to replace traditional animal models. The Ames
mutagenicity/carcinogenicity test uses Salmonella typhimurium
cultures to screen compounds that formerly required the use of animals.
Such systems allow for an almost limitless number of compounds to be
tested which can create an interesting dilemma. The more compounds that
can undergo screening, the more compounds that will be potentially
available to test in animals. Alternative techniques can replace the
number of animals at a given step in the screening process. However, use
of alternatives may increase the number of compounds that must be finally
tested in intact animals.
Plants, - Plants offer another alternative living
system which can be used to replace animals in studies of basic molecular
mechanisms. There is very little morphological and functional difference
between the organelles isolated from plants and those isolated from
animals. The rigid cell wall of plants, however limits their applicability
for use as undisrupted cells.
Use of Nonliving Systems
Chemical Techniques - The most widely used nonliving
model system involves the use of modern chemical techniques. This is
particularly true of the analytical techniques which can be used to
identify substances and to determine their concentration or potency.
Immunochemical techniques use the binding capacity of highly specific
antibodies to seek out minute quantities of antigen. A classical example
of this technique can be demonstrated by the currently used techniques for
identifying bacterial toxins. Toxin identification previously required the
injection of as many as several hundred mice with supernatant from
cultures of suspected contaminating bacteria.
These new antibody techniques save animals and speed up confirmation of a
tentative diagnosis. By adding a color marker to the Enzyme Linked
Immunosorbent Assay system (ELISA), the whole process becomes a
commercially available test kit such as those used in home pregnancy
detection. A test that previously required the use of a rabbit now can be
performed using an over-the-counter test kit. There are a variety of
chemical techniques that can be used to determine the presence of a
particular chemical reaction or the presence of an enzyme necessary for a
specific reaction. At the most basic level, the identification of a
particular chemical structure in a compound can provide a great deal of
insight into the potential reactivity and thus the resulting toxicity of a
given substance.
Physical and/or Mechanical Systems - The use of physical
and/or mechanical systems to replace living animals of even the highest
order has application in teaching specific skills and/or reactions to a
well defined set of predetermined circumstances. The use of
computer-linked mannequins in teaching basic principles of medicine and
applied techniques can be best illustrated by the mannequins used to train
people in cardiopulmonary resuscitation.
Historical data can be used for analyses in a variety of databases
commonly used in the field of epidemiology. However, while the body of
potentially useful information that already exists in a variety of sources
is immense, it may not always be in a format which permits ready
accessibility for evaluation. For this reason, retrospective
epidemiological studies are often the subject of fairly heated debates.
Yet with the increasing access to historical data available on existing
computer programs, this problem may to a large extent be overcome in the
future.
Use of Computer Simulation
The standout in the alternative techniques controversy is the claim
made for computer simulation as a means of virtually replacing the use of
living animals. In order for a biological phenomena to be adapted to a
computer model, the basic processes must be expressed in a mathematical
formula. Once a formula is developed then an enormous number of variables
can be introduced and swiftly processed. The key element for success is
the generation of a program from the mathematical formula. The more
complete the formula, the more useful the program. The problem is that
many of the questions being asked of an animal model are not defined well
enough to develop the necessary mathematical model. As the core knowledge
of the biological processes expands so will the opportunities to use
computer simulation to replace the number of live animals being used.
REDUCTION
In discussing the ways to reduce the numbers of animals used, the
definition of an animal and the principle of moving down the phylogenic
scale must also be kept in mind. The four broad categories for reducing
the number of animals used are:
Animal Sharing
Improved Statistical Design
Phylogenic Reduction
Better Quality Animals
Animal Sharing
Sharing of animals can significantly reduce the number of animals used
within a given institution. Between institutions, sharing is more
difficult, but can be effective as demonstrated with the Primate Supply
Information Clearinghouse, Regional Primate Research Center (SJ-50)
University of Washington, Seattle, WA 98195. This service has reduced the
total number of primates used by helping to optimize the usage of those
already in facilities throughout the country.
Sharing can be as simple as allowing someone to practice a surgical
approach on an animal that has been, or is to be euthanatized for other
purposes, or providing organs or tissues at the time of necropsy. Sharing
becomes more complicated when attempting to maximize the use of control
animals, but it can significantly reduce the number used within an
institution. If two studies involve the need to perform a sham operation,
the administration of compounds by identical routes, the use of standard
control diets or the need to condition animals to a particular
environment, control animals could be shared within the institution.
Animal sharing would require some form of centralized clearing process
within the Institutional Animal Care Program to match the needs of the
various investigators and their studies.
Improved Statistical Design
Anyone who has ever taken a course in experimental design or applied
statistics has been bombarded with the importance of consulting with the
statistician during the design phase of the experiment and not when the
data collected needs to be analyzed. Improper design of experimental
protocols and/or the failure to use appropriate statistical methods can
result in the usage of an inappropriate number of experimental animals. A
variety of design strategies are available which can reduce the number of
animals needed in a given study. Experimental protocols which utilize
serial sacrifice, group sequential testing and crossover designs can
significantly reduce the numbers of animals required.
The availability of low cost statistical packages for almost every
computer on the market permits more and more investigators access to
sophisticated data management and analysis. This accessibility makes
possible the use of design criteria and complicated statistical analysis
which heretofore have been largely confined to institutions with large
statistical support units. With this ability at their finger tips,
investigators should be able to maximize the analysis of the data
generated from each animal used, thus reducing the total numbers of
animals necessary for a particular set of data.
Phylogenic Reduction
Projects which can be designed to use one of the myriad of invertebrate
species instead of a non-human primate species represent a type of
phylogenic reduction which was discussed as a replacement technique.
Such broad jumps across the phylogenic scale are not always possible,
but less dramatic shifts can significantly reduce the numbers of higher
species being used in research, teaching and testing. In many instances,
the theory of phylogenic reduction has been blurred by a specie's use as
a companion animal with little regard for phylogenic ranking. The
animals chosen for project usage should be the least advanced from a
phylogenic standpoint that will provide the necessary data.
The principle of phylogenic reduction is generally well accepted as a
way to reduce the number of animals used, but it often brings many hidden
difficulties. As one descends the phylogenic scale, the available
information on the maintenance and use of these animals in a biomedical
setting often becomes difficult, if not impossible, to obtain. When
choosing a study model, it is critical that the principal investigator
take into account the ability of the institution to provide appropriate
care for the species chosen. Phylogenic reduction is an important means
of decreasing the number of animals used, but should be practiced
carefully and with the full knowledge of the requirements of the species
chosen.
Better Quality Animals
It is a rare study in which the initial cost of the animals to be used
represents the single most expensive aspect of the study. For this reason
it can often be false economy to select the source of the animal based on
cost alone. When purchasing laboratory animals, it is important to keep in
mind that cost and quality are usually directly correlated. By choosing
the best quality animal in terms of health status, the possibility that
animals will be lost or data compromised by the intrusion of a concurrent
disease condition is minimized, if not eliminated. Choosing the best
quality animals, in terms of genetic status, will virtually insure the
consistency of animals from study to study. This requires an institutional
commitment to the use of animals of defined health status and limits the
investigators to the animal sources approved by the institution. Mixing of
animals of different health status is a disaster waiting to happen and may
negate all the benefits derived from the use of quality animals.
The role of the investigator and staff in assuring the integrity of an
animal colony cannot be overemphasized. In choosing a source of animals, a
veterinarian should be consulted to insure that the best animals that can
be effectively maintained in the institution are purchased. Animals of
different or unknown health status should never share the same environment
nor common equipment in the animal facility or in the research laboratory.
REFINEMENT
Refinement refers to techniques which reduce the pain and distress to
which an animal is subjected. For the purpose of this manual these
techniques can be classified into the following broad categories:
Decreased Invasiveness
Improved Instrumentation
Improved Control of Pain
Improved Control of Techniques
Decreased Invasiveness
A hallmark of most of the new diagnostic and therapeutic techniques
used in human medicine is the minimal degree of invasiveness that is
required to successfully perform a procedure to obtain a given set of
data. In many instances these techniques are applicable in the research
environment and can be adopted for use in animals. A sophisticated example
could be the use of Magnetic Resonance Imaging for results that formerly
required euthanasia of multiple animals along a time curve to obtain assay
tissue. Today one animal can provide all the information along a given
curve. A less dramatic example is the vascular access device which permits
repeated samples or injections in a single animal instead of using several
animals. Invasiveness reduction methods are available in almost every area
of biomedical research, and in project design, it is important to identify
and use these methods wherever possible. Not only do they represent an
alternative technique, but they generally provide much more consistent and
reproducible data.
Improved Instrumentation
Monitoring Animals - In this age of microelectronics,
fiber optics and laser instrumentation, the potential for refining
techniques used in animal experimentation seems almost limitless. Improved
instrumentation can minimize animal distress by reducing the level of
restraint and/or manipulation necessary to obtain biological samples.
Included in this category are the use of tethers in a variety of species
to allow continuous access to the various organ systems, while permitting
the animal virtually unrestricted movement within its primary enclosure.
The advantages of these systems are numerous, not the least of which is
minimizing a variety of non-experimental variables associated with
prolonged restraint.
Analyzing Samples - Once obtained, samples can be analyzed
in very small volumes for a multitude of parameters. Examples of this can
be found in the commercially available diagnostic laboratory equipment
which require only microliter blood samples to perform a variety of
diagnostic tests. The use of smaller sample sizes permits the use of
smaller animal species and prevents the need to euthanatize many of these
species to obtain the necessary volume of blood. It is now possible to
obtain serial blood samples from small laboratory rodents which reduces
the number of animals necessary to obtain data over the length of the
study.
Improved Control of Pain
The Animal Welfare Act requires "that the principal investigator
consider alternatives to any procedure likely to produce pain or distress
in an experimental animal" and in any practice which could cause pain to
animals that a doctor of veterinary medicine is consulted in the planning
of such procedures for the use of tranquilizers, analgesics and
anesthetics. Since appropriate anesthetic and analgesic agents can
minimize the potential pain and distress experienced by animals, an entire
chapter of this manual is devoted to the principles of using these agents.
Suffice it to say, that of all the possible ways that the 3 R's can be
utilized this is an area where the laboratory animal veterinarian can
often be of most help to the investigator.
Improved Control of Techniques
Proficiency in the handling and restraint of animals makes it easier to
perform a variety of routine procedures with minimal or no pain or
distress to the animals involved. Animals are creatures of habit and when
proper handling is part of their regular routine, the degree of distress
caused by the procedures is minimized. Animals can be trained or
conditioned to accept a variety of procedures which if suddenly forced
upon them can be distressful. Almost every animal commonly used in the
laboratory responds positively to a little tender loving care. It's
inexpensive, readily portable, safe even at the highest doses and spreads
rapidly through the staff. To develop the proper techniques and gain
confidence in their use requires training by someone with appropriate
experience. This can be the veterinarian, a member of the animal care
staff or a fellow investigator. Whomever it may be should be sought out
before a new species or technique is incorporated into the study. This
will reduce the potential distress of all animals involved in the study up
to and including the principal investigator.
SUMMARY
In this chapter, the use of alternative techniques has been
defined in terms of the present regulatory requirements and the principles
of Replacement, Reduction and Refinement were introduced. In summary, the
reader should consider a fourth R--Responsibility. The use of animals in
teaching and research brings with it a responsibility to minimize animal
pain and distress. The adoption of the 3 R's as part of the process of
planning and conducting projects using laboratory animals will go a long
way toward implementing Responsibility--the fourth R.
REFERENCES
Animal Welfare Act (Title 7 U.S.C. 2131-2156) as amended by PL 99-198,
December 23, 1985.
Guide for the Care and Use of Laboratory Animals, NIH Publication
No. 86-23.
Models for Biomedical Research: A New Perspective, l985. National
Academy Press, Washington, DC; l985.
Navian, J.B. Animal Models in Dental Research. The University of
Alabama Press.
Paton, William. Man & Mouse Animals in Medical Research. Oxford
University Press, New York, 1984.
Public Health Service Policy on Humane Care and Use of Laboratory
Animals. Revised as of September 1986.
Public Law 99-198. Code of Federal Regulations, Title 9, Subchapter A,
Animal Welfare, 1989.
Rowan, A.N. Of Mice, Models, & Men: A Critical Evaluation of Animal
Research. State University of New York, 1984.
Russel, W.M.S. and Burch, R.L. The Principles of Humane Experimental
Technique, Methuen & Co, Ltd., London, 1959.
U. S. Congress, Office of Technology Assessment. Alternatives to Animal
Use in Research, Testing, and Education. (OTA-BA-273, Feb. 1986)
Webster's Ninth New Collegiate Dictionary, Merriam-Webster, Inc.,
Spring- field, MA; 1986.
Wessler, S. 1976. Animal Models of Thrombosis and Hemorrhagic Diseases,
NIH Publication No. 76-982.
Chapter 3
Animal Care and Use: A Nonexperimental Variable
John C. Schofield, B.V.Sc., M.R.C.V.S. and Marilyn J. Brown, D.V.M.,
M.S.
INTRODUCTION
The response of a laboratory animal to an experimental variable is
influenced by a variety of genetic and environmental factors. An
understanding of these factors is necessary to control their affects and
minimize the potential influence of non-experimental variability on the
final outcome of a given experimental protocol. Minimizing non-experimental
variability can optimize the use of animals in a given study.
Since the 1930's, the concept of genetic makeup, or genotype of an
animal, combining with the developmental environment to produce the
phenotypic expression of the animal had been well accepted. A useful
concept concerning the relationship of genetic and environmental factors,
'dramatype', was
proposed by Russell and Burch in 1959. They defined dramatype to be the
pattern of performance in a single physiological response of short
duration relative to the animal's life time. It is determined by phenotype
and the immediate environment in which the response is elicited. This
concept distinguishes between the developmental environment, which
directly interacts with genetic factors, and the proximate or immediate
environment, which acts upon the combined system. Simplified, genotype
plus developmental environment equals phenotype and phenotype plus the
immediate environment equals dramatype. This concept stresses the
interrelation of the genetic background of the animal, the environment in
which it is raised and housed and the laboratory environment in which the
animal is used or tested.
Genotype may be controlled through the use of genetically defined
animals produced in structured breeding systems or by genetic engineering.
This is easiest to accomplish through the purchase of genetically defined
animals from reputable suppliers. In-house breeding programs are difficult
and time consuming to maintain in a manner which assures genotypic
integrity. If such colonies must be used, it is advisable to consult a
geneticist to design a breeding program that produces animals of defined
genetic characteristics. A genetic monitoring program might also be
required to define the genetic makeup of the animals produced. This can be
an expensive proposition and requires some expertise to perform. The
phenotype can be influenced by regulating environmental conditions in
which the animals are reared. For uniform dramatype, the environmental
conditions in which the animals are tested must be controlled.
This chapter will deal with three broad categories of non-experimental
variables: physical factors, chemical factors and microbial factors.
Physical factors which will be discussed include: cage design and
construction, temperature, humidity, ventilation, light intensity and
photoperiodicity, noise, bedding, watering systems, feeding, housing
systems, shipping and handling. Chemical factors to be discussed will
include contaminants of food, water, bedding, and air. Microbial factors
will be discussed in terms of some of the common viral, bacterial and
parasitic diseases that can affect laboratory animals. The total of all of
the components included in these three broad categories combines with the
animal's genetic background to constitute Russell and Burch's concept of
phenotype and dramatype. It is important to appreciate that our knowledge
of the effects of non-experimental variables is rapidly expanding and the
purpose of this chapter is to introduce the reader to this subject rather
than present an exhaustive or complete treatise.
PHYSICAL FACTORS
The physical environment of laboratory animals may be considered to
consist of the animal room, or macroenvironment, and the primary enclosure
(cage), or microenvironment. Cage design and composition influence the
interaction between micro and macroenvironment. Therefore the temperature,
humidity, airflow, concentration of waste gases, illumination and noise
levels within the cage may be quite different from that monitored at the
room level. Each of these factors represents an important non-experimental
variable that will be discussed in more detail.
Cage Design
Cage design and construction material can influence the study results.
Galvanized caging material or rubber bottle stoppers can serve as a source
of trace minerals which could affect the results of studies where the
level of these com- pounds is being controlled. Other important
considerations include whether con- tact bedding can be used or if animals
must be housed on a wire floor. The type of sample collection may require
the use of a metabolic cage, or observation studies may require the use of
clear rather than opaque caging. The behavioral characteristics of the
animal will also dictate the type of cage design used. For example, some
animals require perches, nesting boxes or hiding places, and others
require built-in restraint devices such as the squeeze mechanisms often
found in primate caging. Reproductive needs may require specific caging
features. In some species the male must have a method of escape from an
overaggressive female. Many neonates have inadequate homeothermic
mechanisms and will become hypothermic if not protected by contact bedding
or nesting material placed in the cages.
Temperature and Humidity
The temperature and humidity in the animal room (macroenvironment)
should be monitored and maintained within published acceptable limits. The
temperature and humidity in the microenvironment is more difficult to
monitor and control. Variations in temperature and humidity are influenced
by such factors as filter tops, hanging wire or solid bottom caging,
population density, animal activity level, cage location, and temperature
and humidity in the animal room itself. Variations in temperature and
humidity can have a variety of effects. For example, exposure to high
temperatures will frequently cause rabbits to lick their fur which can
predispose them to the formation of hairballs. Very low humidity has been
associated with a rodent lesion called ring tail which is characterized by
annular constrictions and can result in loss of the tail. More subtle
temperature and humidity effects include: altered drug metabolism,
increased disease susceptibility and decreased reproductive efficiency.
These examples serve to illustrate the need for controlled temperature and
humidity in the animals' micro and macroenvironment and the vital role it
plays in the generation of consistent, reliable data.
Ventilation
Ventilation in animal rooms can have significant impact on the health
status of the occupants. Excessive odor is often the first indication of a
ventilation problem in an animal room; however, the concentration of waste
gases at the cage level is usually higher than those detected at the room
level. Furthermore, the concentrations capable of causing pathology are
much less than human sensory threshold levels. Many design features affect
room ventilation including the location, number, and configuration of
supply and exhaust ducts. Cage-level ventilation is further affected by
the presence and/or type of filter top on the cage as well as the design
and location of the cage relative to the room airflow pattern. Ventilation
should be such that it keeps the concentration of waste gases to a
minimum, reduces the spread of disease, provides a stable temperature and
humidity and avoids drafts.
Lighting
Light intensity and photoperiodicity in animal rooms can affect
reproductive function and animal vision. The recommendation of the Guide
for light intensity in animal rooms is 75-125 footcandles (fc). However,
prolonged exposure to such levels can cause irreversible retinal
degeneration in albino rodents and 25 fc has been suggested as a more
appropriate intensity for these species. Variable light intensity control
devices such as dimmer switches or multiple bank lighting can be installed
to facilitate adequate light for observation and husbandry yet provide
lower intensity light for general animal housing. Cage position on a rack
can be an important factor and an 80-fold difference in light intensity
can exist between the upper and lower shelf locations. Photoperiods or
light/dark cycles (usually given in hours as L:D) can modify reproductive
behavior and circadian rhythms. A daily light cycle which has 12 to 14
hours of light is usually recommended for most species. It is important to
keep the light intensity and periodicity constant. Animal rooms should be
equipped with automatic light timers. The presence of windows, either to
the outside or to the corridor, can affect reproduction in some animals.
Corridor windows may be desirable for observational purposes, but they can
provide enough light to affect circadian rhythms in nocturnal animals. As
with all environmental factors, the special characteristics of the animal
should be taken into consideration when planning light cycles. Duration
and type of light can affect estrus behavior. Animals can have their
reproductive cycles manipulated by changing the light cycle. This
technique has been used in several rodent species, cats, and farm animals.
Reversed light cycles can be used to accommodate circadian rhythm, sleep
and breeding studies within the normal working hours in an institution.
Individual room timers provide a facility with more flexibility to meet a
variety of experimental requirements.
Noise
Excessive noise can also disrupt animal breeding behavior. Noise at
excessive levels can cause mechanical damage to the auditory system in
both animals and man. Some effects of noise in animals include audiogenic
seizures, eosinophilia, increased serum cholesterol levels and increased
adrenal weights. It is recommended that noise levels in animal facilities
not exceed 85 decibels (db).
Caging Accessories
In addition to the microenvironmental effects of the physical
configuration of the primary enclosure as discussed above, other aspects
of the cage environment should be considered. The presence or absence of
bedding material is dependent on the species and situation. For example,
many breeding programs utilize some form of bedding to improve neonatal
survival. An ideal bedding material should be dustfree, non-palatable,
absorbent, and free of microbial and toxic contaminants. The choice of
watering system depends on species, experimental design, and management
factors. Automatic watering systems are expensive to install but can pay
for themselves in labor savings over time. Automatic watering systems
should be flushed daily when used with low flow rates, such as in rodent
rooms, to avoid stagnation and minimize bacterial buildup. When the study
protocol requires delivery of a compound in the water, or measurement of
daily intake is needed, water bottles or pans are often used. Choice of
feeder and type of food is also species and situation dependent. Some
species such as the hamster are frequently fed on the floor of the cage
because their broad muzzle can make obtaining food from some rodent
feeders difficult. Some species such as rabbits do not readily tolerate
sudden changes in diet composition or formulation. When de- signing a
study, it is important to consult someone knowledgeable in the biology and
husbandry requirements of the species to be used, so that wherever
possible, species variations are taken into consideration.
Cage Size - Occupancy Standards
Consideration should also be given to the cage size. There are specific
cage size requirements set forth in the Guide for the Care and Use of
Laboratory Animals and by the Animal Welfare Act. Cage size
requirements depend upon the species, weight or size of the animal(s),
number of animals in the cage and breeding status. In addition to the
floor space requirements the behavioral characteristics of the species,
strain, and sex must be considered when group-housing animals. For very
social animals, individual housing may cause stress. Even among social
animals, the formation of new groups can result in fatal trauma from
fighting. Male mice will often fight when group housed, whereas male rats
usually do not. Aggressive behavior can be strain specific; for example,
F344 male rats and C57BL mice are generally considered to be more
aggressive than other commonly used strains. Even in docile animals,
overcrowding can lead to fighting, cannibalism and stress. Breeding
activity can be significantly modified by group housing arrangements. For
example, group-housing female mice can lead to anestrus with subsequent
estrus synchronization with the introduction of a male mouse.
Shipping
The effect of shipping animals can be a significant physiological
stress. Studies have documented the that prolonged transport, high ambient
temperatures, lack of water and the potential for microbial contamination
may have on the research data collected from animals exposed to such
factors. The provision of climate-controlled transport vehicles and
filtered crates decreases these stresses. Even under optimal shipping
conditions, it has been shown that it takes 1-5 days for the immune system
and body weights to return to normal. It is also important to remember
that changes in feed, water, and housing conditions can markedly affect
newly arrived animals. Animals should be given an adequate period of time
to equilibrate after transport.
Handling
The frequency and type of handling an animal receives is another
non-experimental variable. Investigators and technicians should be familiar
with and skilled in the correct techniques for handling and restraining
the species involved. This can prevent injury to either the animal or the
handler. Daily husbandry routines may need to be scheduled around the
research needs. Close communication between the investigator and the
animal care staff can minimize handling stress. For example, collection of
biological samples may be performed during routine cage changing. This is
particularly useful when chemical restraint is required for either
function. Since many animals are creatures of habit, regular handling may
reduce stress.
CHEMICALS
Chemicals found in the animal's environment may be inherently toxic or
their metabolism may result in the formation of toxic products. They may
directly injure cells or interfere with cellular homeostasis. The possible
effect of a chemical depends on the concentration, the agent's
physiochemical properties, as well as the duration, frequency and route of
exposure and potential interactions. These chemicals can influence various
body systems. For example, it has been demonstrated that chemicals can
affect hepatic microsomal enzymes which have many functions, including the
biotransformation of drugs and chemicals and regulation of oxygen radical
removal. Such chemical sources include: softwood bedding, room
deodorizers, insecticides, and ammonia. Chemicals can also target the
immune system. Some insecticides cause lymphopenia. Heavy metals can
decrease resistance to disease by the reduction of antibody formation,
altered phagocytic capacity of polymorphonuclear cells and macrophage, and
suppression of interferon production.
Food and Water
Food and water can serve as sources for chemical contamination of
research animals. Drinking water may be contaminated with synthetic
organic solutes such as pesticides. Trihalomethanes are often found in
water supplies as a result of the chlorination process. Some facilities
hyperchlorinate or acidify water to decrease microbial contamination;
however, these techniques can affect the immune response. Inorganic
contaminants may include heavy metals and nitrites. Diets can also be a
source of contaminants such as estrogenic compounds, aflatoxins,
insecticides, and preservatives. These compounds may occur naturally in
plant materials, remain as residues from agricultural use, or be the
result of contamination in storage or the processing procedures.
Commercial diets assayed prior to shipment are available and the results
of this assay are printed on the tag attached to each bag.
Drugs
Drug therapy, prior to or during a study, can compromise the data
obtained. For example, tetracycline alters the immune cell function
through its ability to depress chemotaxis and phagocytosis.
Aminoglycosides can have neuromuscular blocking properties, and can have
negative inotropic effects on cardiac and arterial muscle. Other agents
having neuromuscular depressant activity include tetracycline, lincomycin,
and the polymyxins. It is important that investigators and the animal care
staff communicate about the effect that any medications may have on study
animals prior to the initiation of treatment. Similarly, anthelmintics or
insecticides given by the animal care staff to treat parasitism problems,
could affect research results and must be considered in protocol design.
Anesthetic agents are frequently part of experimental protocols. The
re- searcher should balance appropriate levels of analgesia, anesthesia,
and chemical restraint with the possible effects of these agents on the
experimental results. For example, the dissociative agent ketamine
hydrochloride is widely used in anesthesia and restraint because it is
easy to administer, is effective in a wide range of species and has a wide
margin of safety. Besides the better known cardiovascular effects of
ketamine hydrochloride, this drug also has been shown to affect
intracellular cyclic AMP, cellular permeability and calcium channels. A
pharmacologic knowledge of these drugs will aid in selecting those best
suited for each experimental protocol and allow for more informed
interpretation of results. Consultation with the institutional
veterinarian regarding the use of anesthetics and analgesics during the
planning of potentially painful procedures is now a legal requirement.
MICROBIAL FACTORS
Pathogenic microbial agents can affect research by causing clinical
disease, lesions and death. However, in laboratory animals, infection more
frequently is asymptomatic with carriers who develop overt disease when
stressed by shipping or experimental manipulation. Animals with latent
infection may show no overt disease but research results may be
compromised through subtle physiological, biochemical or histological
changes.
Bacterial Diseases
Species-specific mycoplasmal and bacterial diseases are well
documented. There are a number of these pathogens associated with commonly
used laboratory animal species. For example, mycoplasmosis is an endemic
disease in some conventional rodent colonies. It can cause respiratory and
genital tract infections thereby affecting exercise tolerance, sensitivity
to anesthetic agents, increased susceptibility to other respiratory
pathogens, decreased reproductive efficiency and a variety of immune
system anomalies. The investigator using rabbits should be aware of the
incidence and significance of pasteurellosis as a cause of acute and
chronic disease. Pasteurella multocida is very common in
conventional rabbit colonies and can cause upper and lower respiratory
tract infections, subcutaneous abscesses, middle and inner ear infection
and reproductive tract infections. Some species may serve as asymptomatic
carriers of bacterial infections which can cause severe clinical disease
in other species; therefore different species should not be mixed.
Bordetella bronchiseptica can often be isolated from clinically normal
rabbits and rarely causes disease in that species but it can be a
significant cause of respiratory disease in guinea pigs. In addition to
the species-specific organisms, post-operative infections can be caused by
a myriad of bacterial contaminants normally present in the animal's
environment. It is important that invasive surgical procedures be done
aseptically to minimize the potential affects of these opportunistic
organisms.
Although not experimental variables, there are several bacterial
diseases of laboratory animals which can be transmitted to man and
therefore are of possible concern to those using animals in research.
These may include tuberculosis, salmonellosis, campylobacterosis, and
shigellosis. The investigators whose studies involve substantial animal
contact should be familiar with institutional guidelines and policies
regarding the prevention of zoonotic disease. These should include a
program of periodic physical examination, an educational program for
personnel, immunization where appropriate and the use of protective
clothing.
Viral Diseases
Viral infections in laboratory animals can often be asymptomatic. As
with bacterial and mycoplasmal infection, clinical viral disease can occur
when an animal is stressed. These viruses can be particularly devastating
because the effects on research data may not be recognized, yet still be
significant. The effects of these latent viruses have been best defined in
rats and mice. Barrier housing of commercially available specific
pathogen-free rodents will help eliminate these viruses from a colony.
Contaminated tissues, particularly murine tumors, have been implicated in
many outbreaks of disease. Tissues should be screened for the presence of
contaminants prior to their use in a research facility. It is beyond the
scope of this chapter to review all the research implications of viral
pathogens currently known; however, a few examples will be briefly
mentioned. There are key viral diseases of most common laboratory animals
and it is important for the investigator to work with the institutional
veterinarian to become familiar with those viruses and learn how they
might affect a particular research project.
Sendai virus, a common viral contaminant in conventional mouse and rat
colonies, can cause histopathologic changes in the respiratory tract,
immunosuppression, and decreased reproductive efficiency. It can also act
synergistically with other respiratory pathogens. A viral disease of mice
which is often asymptomatic but serious is Mouse Hepatitis Virus (MHV).
This virus has been implicated in wasting syndromes in nude mice. It can
cause respiratory, hepatic, and enteric disease. Even in asymptomatic
animals, it can cause profound immunological disturbances. Some diseases
of laboratory animals are often associated with clinical disease and
affect a research study due to high morbidity and mortality rather than
the subtle effects of the latent viruses. Canine distemper, feline
panleukopenia and measles in macaques are examples of these types of viral
infections. Although not as prevalent as bacterial zoonoses, some viruses
of laboratory animals can be transmitted to man. Examples of these
include; lymphocytic choriomeningitis, Herpes virus simiae and
rabies.
Parasitic Diseases
Parasites of laboratory animals have also been implicated as
nonexperimental variables in research. Some parasites such as
Trichosomoides crassicauda of rats are capable of causing tumors which
could significantly obscure results of a carcinogenicity study. Skin mites
of mice have been shown to affect immune parameters. Parasites are also
capable of causing significant clinical disease such as the rectal
prolapses seen with pinworms in rodents and bowel perforation seen with
Prosthenorchis elegans in non-human primates. Some parasites of
laboratory animals can also be transmitted to man. Examples of these
parasites are Hymenolepis nana and Entamoeba histolytica.
It is important to remember that while laboratory animals may not show
clinical signs of microbial infection, the infections can have profound
effects on research results. Investigators studying immunological function
should be particularly familiar with the potential effects of microbial
agents on their research. Trans- mission of contaminants can occur in
tumor or tissue inoculation, from direct transmission or via fomites in
the laboratory. Animals of different health status should be strictly
isolated from one another and all biologic material should be screened for
the presence of viral and other contaminants.
SUMMARY
The concepts of Russell and Burch - refinement, replacement, and
reduction are generally well accepted in the research community. Adherence
to these concepts includes attempting to minimize the non-experimental
variables introduced in this chapter. The maintenance of healthy
laboratory animals and the reduction of non-experimental variables is the
responsibility of the animal care facility and the investigator working
together in an atmosphere of open communication and cooperation.
REFERENCES
Allert, J.A.; Adams, R.A.; and Baetjer, A.M. l968. Role of
environmental temperature and humidity in susceptibility to disease.
Ach. Environ. Health 16:565-570.
Broderson, J.R., et al. 1976. The role of ammonia in respiratory
mycoplasmosis of rats. American Journal of Pathology 85:115-130.
Davis, D.E. 1978. Social behavior in a laboratory environment. pp 44-63
in Laboratory Animal Housing. Proceedings of a symposium organized
by the ILAR Committee on Laboratory Animal Housing. Washington, DC;
National Academy of Sciences.
Guide for the Care and Use of Laboratory Animals, NIH
Publication No. 86-23.
Greenman, D.L.P., et al. 1982. Influence of cage shelf level on retinal
atrophy in mice. Lab Animal Science, 32(4):353-356.
Lang, C.M. and Jessell, E.S. 1976. Environmental and Genetic Factors
affecting laboratory animals; impact on biomedical research. Federal
Proceedings Vol. 35 No. 5-8, 1123-1165.
Lindsey, J.R., et al. Physical, chemical and microbial factors
affecting biologic response, pp. 3-43, In: Laboratory Housing.
Proceedings of a symposium organized by the ILAR Committee on Laboratory
Animal Housing. Washington, DC; National Academy of Sciences.
Pakes, S.P. et al., Factors that complicate animal research,
Laboratory Animal Medicine, Chap. 24. Fox, J.G. (ed.), Academic Press.
Public Law 99-198. Code of Federal Regulations, Title 9, subchapter A,
Animal Welfare, 1986.
Russell, W.M.S. and Burch, R.L. The Principles of Humane
Experimental Technique, Methuen & Co., Ltd., London, 1959.
Chapter 4
Principles of Anesthesia and Analgesia
Marilyn J. Brown, D.V.M., M.S.
INTRODUCTION
It is important that all scientists using animals in research meet
their ethical and legal responsibilities to avoid unnecessary pain and
distress to the animal. Studies involving unavoidable pain and distress
must be justified by the investigator in accordance with Federal
regulations and institutional policies. This chapter will cover some of
these legal responsibilities as well as try to help the investigator meet
these responsibilities through knowledge of the basic principles of
anesthesiology. Included in these principles are an understanding of some
of the basic terms used in the field of anesthesiology, the types of
variables that can affect an animal's response to an anesthetic agent, the
effect of a given anesthetic protocol on an experiment, some general
considerations and the recognition of pain. Also mentioned in this chapter
are anesthetic monitoring and some fundamentals of anesthetic crisis
management. Controlled drugs and their use are briefly discussed. This
chapter is not meant to be a complete treatise on the subject of
laboratory animal anesthesiology, but to give an introduction to stimulate
further reading in areas of specific interest.
Anesthesiology is not an exact science. Recommendations and dosages
given in textbooks should be taken as guidelines. An investigator
contemplating a procedure requiring anesthesia, tranquilization or
analgesia should not neglect the resource of a veterinarian who can often
provide valuable assistance. In fact the Animal Welfare Act requires that
"in any practice which could cause pain to animals . . . a doctor of
veterinary medicine is consulted in the planning of such procedures."
There are many variables affecting an animal's response to anesthesia.
Because the absorption and biotransformation of drugs differs between
species, it is nearly impossible to develop a single anesthetic or
analgesic protocol that applies to all laboratory animals. Morphine can
cause profound CNS depression in the rat and rabbit, but can cause tremors
and convulsions in mice and cats. The dosage of xylazine needed to sedate
a ruminant is one-tenth that necessary to sedate a dog. These are but two
of many examples. A common mistake is to extrapolate dosages across animal
species or from man to animals. The strain of animal used is also a
variable to consider. Some rat strains are sensitive to nitrous oxide.
Some breeds of dogs (whippets and greyhounds) are more sensitive to
barbiturates than other breeds. The size and even the sex of the animal
can make a difference in the response to anesthetics. In rats, females are
more sensitive to barbiturates, but in mice, barbiturate narcosis lasts
longer in males. The temperament of the animal can change the way it
responds to a given agent. Some tranquilizers will cause a vicious dog to
become even more difficult to handle.
Fat does not play a key role in the initial absorption of an anesthetic
agent, but it does affect the body weight upon which the dosage is based.
Fat can later serve as a repository for the agent, thus prolonging
recovery. The age of the animal also must be considered. Since very young
animals require frequent feedings, prolonged recoveries can present a
formidable problem. There are also age-related changes in liver enzyme
functions which affect biotransformation of anesthetic agents. Older
animals can present an anesthetic challenge due to impaired renal or
hepatic function.
The animal's physical condition can affect its responses. The presence
of pre-existing disease will increase an animal's anesthetic risk.
Respiratory diseases can often be asymptomatic in the uncompromised animal
even though they are endemic in many rodent populations. Even less obvious
is the effect of diet and environment. Rats fed an inadequate diet are
more resistant to barbiturates, yet fasted mice have an increased
barbiturate sleep time. Abnormal environmental temperatures and humidity
cause stress which can result in a compromised animal and variable
anesthetic responses. High temperatures sensitize rats and rabbits to
anesthesia.
Various factors will influence anesthetic choice. The use of concurrent
drugs changes an animal's response to anesthetic agents. For example, some
antibiotics potentiate barbiturates. The type of experimental procedure
planned may impact on the anesthetic protocol. In an obstetric procedure,
the effects on the fetus must be considered. When surgery involves the
head and face, there is limited access to the animal so the anesthetic
protocol should be planned to facilitate monitoring under these
circumstances.
LEGAL RESPONSIBILITIES
Minimizing pain and distress in research animals is an ethical
responsibility, produces better scientific results and is the law. The
Public Health Service Policy on Humane Care and Use of Laboratory Animal
states that "Procedures that may cause more than momentary or slight pain
or distress to the animals will be performed with appropriate sedation,
analgesia, or anesthesia unless the procedure is justified for scientific
reasons in writing by the investigator." The NIH further addresses the
subject of anesthesia in the Guide for the Care and Use of Laboratory
Animals. This document states that the proper use of anesthetics and
analgesics is necessary for humane and scientific reasons and recommends
that the veterinarian provide guidance for their usage. The Animal Welfare
Act (AWA) requires standards for animal care, treatment, and practices in
experimental procedures to ensure that animal pain and distress are
minimized, including adequate veterinary care with the appropriate use of
anesthetic, analgesic, tranquilizing drugs or euthanasia. It prohibits the
use of paralytics in painful procedures without anesthesia and states
"that the withholding of tranquilizers, anesthesia, analgesia or
euthanasia when scientifically necessary shall continue for only the
necessary period of time." Exceptions to such standards may be made only
when specified by the research protocol and any such exception shall be
detailed and explained in full in a report filed with the Institutional
Animal Committee. And as previously noted, it further requires that if
practices could cause pain to animals, a doctor of veterinary medicine be
consulted in the planning of such procedures.
TERMINOLOGY
As with all branches of science, there are certain terms one needs to
be familiar with in order to communicate effectively about anesthesiology.
The following is a list of the most common terms:
Analgesia - Insensibility to pain without loss of consciousness.
General Anesthesia - Temporary, controllable and reliable loss
of consciousness induced by intoxication of the CNS.
Sedation - Calm state usually accompanied by drowsiness.
Tranquilization - Calmness without drowsiness or
unconsciousness. Analgesia is usually not a feature.
Time to Peak Effect - Time between initial administration and
onset of the maximum expected effect.
Duration of Effect - Length of time peak effect can be expected
to last after a single administration of an anesthetic dose.
Time to Recovery - Time between initial administration and the
ability to stand unaided.
EFFECTS OF ANESTHESIA ON RESEARCH
When anesthesia, analgesia, or chemical restraint is used, it may be
advisable to ascertain any distortion of results by anesthetics through
limited trials. Check the literature and package inserts for the effect of
the agent on the systems being experimentally evaluated. These changes
need to be taken into consideration when evaluating the effect of an
experimental manipulation. Choose the agent which has the least effects on
the systems under investigation. General anesthetics often depress the
cardiovascular and respiratory systems, alter blood gases, lower
metabolism, decrease body temperature, and alter tissue perfusion.
Anesthetics can also produce histopathologic changes.
GENERAL CONSIDERATIONS
Whenever possible, try a new anesthetic protocol in a limited number of
animals before depending on it for surgical or painful procedures involved
in an experiment. This allows determination of suitability for the
anticipated protocol and allows necessary changes to be made before it
effects the data being collected. It also facilitates familiarization with
the anesthetic method to minimize problems later, when attention is often
focused on surgical procedures or data collection.
Pay particular attention to the health of the animal before using it in
an experiment. A preanesthetic checkup is a good idea. To minimize
anesthetic risks, only use healthy animals and allow them to acclimate to
the facility before an anesthetic procedure. Consider the general
adaptation syndrome: alarm increases basal metabolic rate which may
increase the amount of anesthetic needed; however, this is often followed
by an exhaustion phase when less anesthetic is required.
Use the minimal degree of CNS depression necessary for the procedure
that is compatible with the animal's welfare. The degree of depression
required for procedures such as radiographs or blood withdrawal is not the
same as that needed for a thoracotomy or orthopedic procedure. Remember,
during painful procedures, the use of paralytics without anesthesia is
prohibited by law.
Consider if, and to what extent, the anesthetic protocol will affect
the validity of experimental results and how it will react with other
drugs being used. For example, if studying catecholamine effects,
halothane should be avoided since its combination with catecholamines can
cause severe cardiac dysrhythmias.
Even in the absence of sophisticated equipment, try to have some basic
items available to insure adequate ventilation. This includes a source of
oxygen, the use of endotracheal tubes when feasible, and aspiration
suction to remove excessive oral secretions, and/or vomitus.
Regard the conservation of heat as an integral part of anesthetic
management. This is particularly important in small or young animals. A
rectal thermometer can help monitor the animal's body temperature. More
sophisticated thermal monitors are also available. Maintenance of body
temperature is enhanced through the use of external heat sources such as
hot water bottles, thermal blankets and heating pads. Care should be taken
to avoid thermal burns from external heating sources; i.e., electric
heating pads.
Administer warm, balanced salt solutions by continuous I.V. drip
whenever possible. This is not always possible in very small animals but
is especially important for prolonged procedures or when significant blood
loss is expected. Fluids often come in bags which are easy to handle and
when warmed can double for hot water bottles.
Pay particular attention to post-anesthetic care. The anesthetist's
responsibility does not end when the animal is taken off the table. Allow
animals to recover in an environment approaching the normal body
temperature of the species. Maintain intravenous fluid infusions when
possible and have an endotracheal tube in place until the swallowing
reflex is recovered. Be sure the animal is protected from injury, either
self-inflicted or by other animals, during recovery.
Consider the implications for laboratory safety. Scavenging systems
should be used with gaseous agents. Avoid carcinogens such as urethane and
chloroform. Consider flammability when using ether.
RECOGNITION AND
TREATMENT OF PAIN
In the Definition of Terms developed to implement the amended Animal
Welfare Act, a painful procedure is defined as, ". . . any procedure that
would reasonably be expected to cause more than slight and momentary pain
or distress in a human being. . . ." In both humans and most animals the
total pain experience results from an interaction between sensory pathways
and the affective system, which provides the motivational and emotional
component of pain. This varies considerably between species and
individuals within a species.
Understanding the degree of pain involved in various experimental
procedures allows a prediction of animal pain or distress. Physiological
responses to pain can include increased blood pressure and heart rate,
pupillary dilation, increased respiration, and an arousal response on the
electroencephalogram. If baseline values are known for these variables,
they can be monitored for changes.
To detect behavioral signs of pain, one must be familiar with the
animal's normal behavior. Behavioral responses to pain vary between
species, within species, and even within the same animal. General
behaviors to evaluate include: sleeping, feeding, drinking, locomotion,
grooming, exploration, performance in learning and discrimination tasks,
mating behavior, social interactions, and dominance/subservience responses
within the social system.
Typical behavioral signs of acute pain include:
- protecting the painful area
- vocalizing (especially when handled or moving)
- licking, biting, scratching, or shaking the painful area
- restlessness
- lack of mobility
- failure to groom
- abnormal postures
- lack of normal interest in surroundings.
Unless there is evidence to the contrary, assume that a procedure that
causes pain in humans will cause pain in animals. Points to remember are:
- Abdominal surgery appears to be less painful in animals than humans,
probably because most animals do not use their abdominal muscles for
postural support.
Lumbar and thoracic spine surgery in animals also appears to be less
painful than in man, probably due to man's postural requirements.
However procedures involving the cervical spine seem to be more
uncomfortable in animals.
- In animals, chest surgery involving the sternum appears to be more
painful than surgery using a lateral intercostal approach.
- Surgery on the eye, ear or surrounding structures seems to distress
most animals. Signs such as head tilt or shaking, or pawing or rubbing
the area may be seen. Perirectal procedures also seem to produce
discomfort. In addition to analgesia, protection of the affected areas
is indicated.
- Surgery of the femur or humerus also seems to be painful to most
animals, which may be due to large muscle mass trauma.
Pain perception can be influenced by drugs and/or environmental and
behavioral factors. Recovery in familiar surroundings may help to relieve
pain and distress. Acclimatization prior to a procedure may also
facilitate recovery. The environment should be kept stable, minimizing
stimuli that evoke a fearful response in the animal. When appropriate,
interact with the animal through talking or petting. Always handle the
animal in an appropriate manner.
Various analgesics are available to the investigator. These can be
divided into two main categories: the centrally acting agents such as
morphine, butorphanol and buprenorphine; and the peripherally acting
agents such as the anti-inflammatories, aspirin and phenylbutazone. The
short half-lives of many of these agents may cause a labor-intensive
analgesic protocol for the investigator, but creative delivery systems
(such as the osmotic minipumps and tethering systems) and the development
of new drugs such as buprenorphine with longer half-lives (12 hours)
should facilitate meeting the analgesic needs of most laboratory animals.
When designing an analgesic protocol, the investigator should consult with
a veterinarian who is experienced in laboratory animal medicine. This will
help avoid problems with species specific responses such as morphine
sensitivity in cats and mice or the unusually short duration of meperidine
in the dog. Interaction of the analgesic with concurrently used drugs and
the effect of the agent on study results (such as the effect of aspirin on
healing or clotting time) must be taken into consideration when choosing
the best agent for a given situation. Although there is much information
available on the use of various agents in animals, it is not always easily
referenced and may be difficult to find without some guidance.
ANESTHETIC MONITORING
During an anesthetic procedure, the physiologic state of the animal and
the depth of anesthesia should be monitored. This allows the anesthetist
to adjust the depth of anesthesia and to anticipate impending
complications. The degree of jaw tone is an indication of muscle
relaxation. This is easily monitored by trying to open the animal's mouth
-- taking care to avoid the animal's teeth.
Pulse quality is an indication of cardiovascular function. It can be
checked in several areas but is commonly felt in the inguinal region. This
"hands on" evaluation of the animal also gives the anesthetist a crude
indication of the animal's body temperature so that hypo- or hyper-thermic
states can be detected. Capillary refill is also an indication of
cardiovascular function. This is checked by pressing firmly on the mucous
membranes of the gums until they blanche and then releasing the pressure
and noting the time it takes the normal color to return. Full color should
return in less than two seconds. A slow capillary refill time is
suggestive of sluggish blood flow and may be an early indicator of shock.
While checking capillary refill, also note mucous membrane color. White
may indicate shock, while blue may indicate poor oxygenation. In small
rodents, the foot pads or ears offer other areas to check for color.
Another method for monitoring cardiovascular and respiratory function
is through auscultation of the chest. This takes more experience and is
difficult in small rodents. Electrocardiographic monitors are also
available to aid in anesthetic monitoring.
Keeping written records of your anesthetic monitoring and
administration is important for several reasons. They serve as a permanent
record of the procedure and of any complications and when they occurred.
This can help explain unexpected experimental data later. Written records
also help to visualize significant trends which could lead to anesthetic
complications. In addition, written records represent the best method to
clearly document compliance with the AWA.
The aim of anesthesia is to prevent the perception of painful stimuli
without undue depression of physiologic functions. One of the criteria
used to monitor the depth of anesthesia is the animals' response to
stimuli or their reflex responses. Responses vary with the type of
anesthetic used, the species and health status of the animal, and the use
of concurrent drugs, particularly paralytics.
The first reflex lost is usually the righting reflex. This reflex may
be checked by turning the animal over on its back and watching to see if
the animal rolls back over onto its sternum. Obviously an animal that can
right itself is not at a surgical level of anesthesia!
The next reflex usually lost is the swallowing or laryngeal reflex. It
is the loss of this reflex that allows placement of an endotracheal tube
after induction. Once in place, slight manipulation of the tube will cause
the animal to swallow, if it is waking up. With some commonly used
anesthetics such as the dissociative, ketamine, the laryngeal reflex may
be present even when a surgical level of anesthesia is obtained.
The palpebral or eyelid reflex is an easy one to monitor. A light touch
to the medial canthus or brush of the eyelashes will cause eyelid movement
if the reflex is present. It may be as obvious as a blink or just a slight
muscle movement. An overly aggressive touch may cause movement that is not
induced by the animal and can lead to erroneous interpretation.
The reflex most commonly used to determine if the animal is feeling
deep pain is the pedal or paw pinch reflex. The toe is firmly pinched
between the fingers to elicit a withdrawal response by the animal. A
forcep may also be used but care must be taken not to cause tissue damage.
Pinching the ear can also be used especially in rodents and rabbits. If
the animal draws its head away or shakes its ear, it is still capable of
feeling deep pain and is not ready for any surgical manipulations.
The pupillary reflex can also be monitored but it can be affected by
many things. Common preanesthetic agents often make the pupil unresponsive
to light. A dilated pupil can indicate either very light anesthesia and
the perception of pain or dangerously deep anesthesia if the pupil is
fixed and dilated.
The corneal reflex is usually the last to go and it is usually not
necessary to get to this depth of anesthesia. This reflex is checked by
very gently touching the animal's cornea and watching for movement of the
eyelid.
STAGES AND PLANES OF GENERAL ANESTHESIA
General anesthesia is divided into stages and planes. Stage one is
characterized by analgesia. In stage two, excitement can be seen. Signs
include struggling and erratic movement. It is preferable to avoid this
stage. Stage three is a surgical level of anesthesia. It is further
divided into planes. Plane one is characterized by a loss of the palpebral
reflex. In plane two, eyeball movement ceases and the animal exhibits
deep, regular respirations. This is usually a good level at which to do
surgery. With plane three comes paralysis of the intercostal muscles and
short, jerky, gasping diaphragmatic efforts. Artificial ventilation is
essential at this plane. Stage four is one to avoid as it is characterized
by total loss of respiratory movements, cyanosis and cardiac arrest.
SPECIFIC AGENTS
It is not within the scope of this chapter to give a detailed
pharmacologic description of all the anesthetic agents and regimes used in
research animals. However, a brief description of the advantages and
disadvantages of some of the most commonly used agents will be given. The
reader is referred to the list of references and a veterinarian when help
is needed to design an appropriate anesthetic protocol for a given
research project.
Preanesthetics
Preanesthetics are usually given as an anesthetic agent adjunct to
ameliorate some of the deleterious side effects and/or to decrease the
required dose of the primary anesthetic agent. Atropine or its analogs are
commonly given. They depress secretory activity making them especially
useful in animals with profuse oral secretions such as ruminants and
guinea pigs. These agents also help maintain heart rate by counteracting
the vagal slowing of the heart rate induced by some anesthetic agents and
some surgical procedures. Atropine causes pupillary dilation, therefore
this reflex cannot be used to monitor anesthetic depth in the atropinized
animal.
Other commonly used preanesthetics are tranquilizers and sedatives. Use
of these agents helps provide a stress-free subject for the induction of
anesthesia. Acepromazine produces good tranquilization, indirectly
suppresses the emetic center, potentiates the analgesic effects of other
agents and provides muscle relaxation. Hypotension can be a serious side
effect of this agent. It is often used in combination with the
dissociative anesthetic agents such as ketamine. Xylazine is a potent
hypnotic, muscle relaxant, and analgesic. Use of this agent can reduce the
necessary barbiturate dose by 50 percent. Like acepromazine, xylazine is
often used in combination with ketamine. Bradycardia and hypotension can
be seen with xylazine. Premedication with atropine can help prevent
cardiac dysrhythmias. Respiratory rate can be decreased, but increased
tidal volume usually maintains normal blood gases. Xylazine can cause
abortion in late pregnancy in ruminants. Diazepam is a potent tranquilizer
which also has muscle relaxant and anticonvulsant properties. It is useful
in combination, particularly with Innovar-Vet(R) in rodents. Although
diazepam can cause some respiratory depression, it has little effect on
cardiac output or blood pressure. Morphine is a narcotic analgesic
sedative. Anesthetic doses can be decreased as much as 50 percent after
morphine administration. Morphine depresses the central nervous system,
particularly the respiratory center, as well as peristalsis. In dogs,
morphine frequently causes emesis. Morphine is generally contraindicated
in the cat and mouse.
General Anesthetic: Injectable
General anesthesia is delivered by two basic methods: injection and
inhalation. It is usually preferable to give injectable agents by the
intravenous route (I.V.) given to effect; however, intraperitoneal (I.P.),
subcutaneous (S.C.) or intramuscular (I.M.) techniques are sometimes
necessary or even preferable. The advantages of injectable anesthetic
agents are ease of administration, low cost and lack of need for
sophisticated equipment. The major disadvantage is that once the drug is
given, it is in the body until it is metabolized or excreted.
Innovar-Vet(R) is a veterinary drug which combines fentanyl, a morphine
derivative, and droperidol, an alpha adrenergic blocker. Because it is a
combination drug, doses are usually given in ml/kg rather than mg/kg. It
is a potent analgesic. The cardiac depressant effects can be counteracted
with atropine and the respiratory depressant effects can be reversed with
naloxone. Innovar-Vet(R) is a poor muscle relaxant. It is not recommended
for use in horses, ruminants, or cats.
Ketamine is a commonly used dissociative anesthetic. It is short acting
and produces variable analgesia. It is often combined with other agents to
improve its muscle relaxation and analgesic properties as well as provide
a smoother recovery. It can be given I.V., S.C., I.M or I.P. It does not
cause cardiac depression and may even stimulate the cardiovascular system;
however, mild respiratory depression may be seen. The swallowing reflex is
maintained making intubation under ketamine alone difficult. The palpebral
reflex is lost, so it is necessary to use ophthalmic ointment to prevent
corneal drying.
The most commonly used injectable anesthetic agents are the
barbiturates. There are two classes of barbiturates: oxybarbiturates of
which pentobarbital or nembutal is the most common; and thiobarbiturates,
such as thiopental, which is much faster acting. Barbiturates are
potentiated by acidosis such as that which can be seen with respiratory
depression or diarrhea. Many drugs potentiate the effect of barbiturates.
Glucose or epinephrine cause prolonged recovery times. Barbiturates are
controlled substances as defined by the Drug Enforcement Agency. Therefore
a license is required for purchase and records must be kept. If possible,
barbiturates should be given to effect which is difficult when
administered I.P. They have an accumulative effect, which means two
subsequent doses combined have a greater effect than the two doses given
alone. Barbiturates are considered poor analgesics. Respiratory depression
can lead to hypercarbia. Cardiovascular effects include bradycardia,
hypotension, myocardial depression, and increased peripheral vascular
resistance. Use of barbiturates is contraindicated in animals with liver
or kidney disease. Lower doses should be used in young animals. When small
doses must be given, it is often helpful to dilute stock barbiturate
solution. Preanesthetics should be used when possible to decrease the
amount of barbiturate needed.
General Anesthetics: Inhalation
Inhalation anesthesia has the advantages of rapid induction and
recovery. Depth of anesthesia can be rapidly changed. Typically animals
are initially anesthetized with an I.V. injection of an ultrashort acting
barbiturate, or administered the inhalation agent by mask or by use of an
induction chamber. When using gaseous anesthetic agents particular
attention must be paid to provide an adequate oxygen source and for the
removal of carbon dioxide. This can be done through the use of a properly
maintained gas anesthesia machine. If possible, it is preferable to
intubate the animal for the most efficient delivery system and to help
assure a patent airway. This takes practice, especially in rodents. If the
anesthesia is administered by mask, avoid placement of the mask over the
entire face as these agents are irritating to the eyes. Also avoid direct
contact of the liquid form of the agent with the animal's skin or mucous
membranes. Scavenging systems should be in place to minimize personnel
exposure.
Nitrous oxide is often used in conjunction with an anesthetic gas due
to its potentiating effect. It is always used in combination with oxygen,
usually at a 50:50 or 60:40 ratio. It is quite safe, since it is neither
flammable nor explosive, allows rapid induction and causes little
cardiovascular disturbance. It is also a very good analgesic. It enters
air-filled cavities much faster than it leaves them which could be a
problem with a pneumothorax or a large gas-filled bowel. Oxygen should be
administered alone for a few minutes at the end of a procedure to prevent
diffusion anoxia.
A commonly used gaseous anesthetic agent is ether. Ether has a slow
induction and recover period. It is highly flammable and forms explosive
mixtures with oxygen and nitrous oxide. It is a potent CNS depressant and
analgesic. It is extremely irritating to the mucosal lining of the
respiratory tract and may induce laryngospasms, especially in cats and
rabbits. Respiratory secretions are stimulated which can predispose or
exacerbate respiratory infections. The respiratory depression caused is
usually only a problem in guinea pigs and chinchillas. Ether causes some
myocardial depression. Since ether is inexpensive and can be administered
without the use of sophisticated equipment, it is very popular. To
minimize explosive hazards and personnel exposure, ether should be used
under a fume hood.
Three other commonly used inhalation agents are halothane, isoflurane
and methoxyflurane. Halothane is nonflammable and nonexplosive. It is a
good muscle relaxant and adequate analgesic. It allows rapid, smooth
induction and recovery. Halothane depresses the cardiovascular system and
sensitizes the heart to dysrhythmias. It also depresses the respiratory
system which can lead to acidosis. Halothane requires special vaporizers
and equipment. Isoflurane is also a stable, nonflammable agent. Induction
and recovery are rapid. Arterial blood pressure is decreased due to
lowered peripheral vascular resistance; however, perfusion is maintained.
Other cardiovascular functions are well maintained, but respiratory
function is depressed. Isoflurance also requires special vaporizers and
equipment. Methoxyflurane is very stable and because it does not reach
high concentrations at room temperature, it has a good margin of patient
safety. It is a good muscle relaxant and an excellent analgesic. Like the
other inhalation agents, it does cause some respiratory depression and
hypotension can also be a problem. Induction and recovery are slower than
with the other agents which may be an advantage by keepin |