Comparative Medicine SOP #: 204. 01 Page: 1 of 10 Post-operative care for large animals (survival) surgeries The intent of the Standard Operating Procedure (SOP) is to describe post-operative care for large animal survival surgeries at NUS by CM staff and research investigators. This SOP is approved by the NUS Institutional Animal Care and Use Committee (IACUC). Any deviation must be approved by the IACUC in advance. TABLE OF CONTENTS 1. Introduction 2. Procedures 3. Personnel safety 4. Animal related contingencies 5. References 6. Appendix 1. INTRODUCTION The intent of the SOP is to facilitate smooth recovery from anesthesia for post-surgical large animals (rabbits, pigs). It also intends to describe post-operative care for nonrodent (rabbits, pigs) surgeries at NUS. This SOP does not apply to the following animals: mice, rats, guinea pigs. 2. PROCEDURES a. Move the animal to an empty, warm and dry recovery cage. Portable oxygen and warmer will be provided if needed for maintenance of warmth and oxygenation if required. b. Monitor vital signs (Heart Rate, Respiratory Rate, Temperature, Oxygen saturation) every 15 minutes until the animal has fully recovered (able to stand or remain in sternal position). Please consult CM veterinary staff if you have any questions regarding operation of equipment. c. Record vital signs readings on the anesthesia record form. A copy of the anesthesia record form is attached in Appendix A. d. Return the animal to its recovery mobile pen in the preparation room. When it has fully recovered from anesthesia, as indicated by the ability to ambulate and maintain core body temperature, return the animal to its home pen. Remove the catheter and discontinue the fluid. e. Place a blue tag (post surgery) and indicate on the cage card the date of surgery and procedures performed on the animal and update the clinical and research notes (appendix B). If post-operative complications (hypothermia, laryngospasms, abnormal heart rate/ respiratory rate) are noted, contact the CM veterinary staff immediately. f. The veterinarians will determine the need for further supportive care (e.g. fluid,
SOP#:204. 01 Page: 2 of 10 electrolytes) based on the animal s condition and the procedures performed unless specified in the approved animal care and use protocol. g. Administer analgesics and antibiotics, as indicated in the approved IACUC protocol, and record this information on the clinical research notes and post procedure record (Appendix B). Refer to SOP on analgesic and post operative care. h. Examine the animal (whether the animal is bright, alert, and responsive) at least twice daily for the first 72 hours and daily for next 4 days or until the incisions are completely healed. Examine the incision site for redness, discharge, or swelling, and ensure that the animal is eating, drinking, defecating and urinating, normally. i. Temperature, heart rate, pulse and respiration should be monitored during this period. j. Personnel-in-charge can refer to the initial animal inventory and procedure record for the health history of the animals (Appendix C). k. Any clinical observations (Appendix D) showing the animal in pain or distress should be noted and recorded in the clinical research notes (Appendix B). If it is considered as a clinical case, please refer to SOP #610 on reporting of sick animals. Follow ups to address the clinical observations should be made and recorded accordingly. l. Remove external skin sutures (if any) after 10-14 days, m. Complete and return the clinical research notes and post procedure record (Appendix B) must be completed and returned to the designated area after the surgery. 3. PERSONNEL SAFETY a. Sharps and needles are not to be recapped after use. b. Sharps and needles are to be disposed into the sharp bin. c. Staff has to wear proper PPEs when attending to the animal. 4. ANIMAL RELATED CONTINGENCIES In cases of veterinary emergency, the veterinary care team could be contacted by HP: 90013073, including after office hours and on weekends and holiday. 5. REFERENCES Guide for the Care and Use of Research Animals, Eighth Edition. National Research Council; National Academy Press, Washington, DC. 2011. Guidelines for the Care and Use of Animals for Scientific Purposes. National Advisory Committee for Laboratory Animal Research, 2004.
SOP #: 204. 01 Page: 3 of 10 http://www.ava.gov.sg/nr/rdonlyres/c64255c0-3933-4ebc-b869-4621a9bf682/13557/attach3_animalsforscientificpurposes.pdf Swindle M. Michael. 2004.Technical Bulletin: Perioperative care of swine. Pages 1-4. Swindle M. Michael. 2004.Technical Bulletin:Pain assessment in swine. Pages 1-2. http://www.research.cornell.edu/care/documents/acups/acup209.pdf http://www.sinclairresearch.com/downloads/technicalbulletins/pain%20assessment% 20in%20Swine.pdf http://www.purdue.edu/research/vpr/rschadmin/rschoversight/animals/forms/pacuc_pain _recog.pdf https://www.aalaslearninglibrary.org/demo/course2.asp?strkeyid=54477445-6518- 4486-BF05-D93C39E42077-0&Library=10&Track=11&Series=17&Course=2577&Lesson=27612 Revision # Author IACUC Approval/Effective Date SOP #:.01 James Low 26 November 2012 204.01 6. APPENDIX Appendix A- (Please refer to next page)
Appendix B
Appendix C
Appendix D 1. Clinical signs of animals in pain or distress: Criteria: Body weight loss compared to the initial body weight before the surgery Inappetence/ dehydration Severe or chronic pain Moribund state Weakness/impaired ambulation Abnormal behaviour Guarding or protecting an affected area (e.g., surgical incision, implant site) Squeaking, squealing, crying out, grunting, growling, hissing, teeth grinding, whimpering or other forms of vocalization Guarding or protecting an affected area (e.g., surgical incision, implant site) Self-mutilation / attraction to area of pain as evidenced by licking, biting, scratching Change in posture or an abnormal posture such as hunching, huddling, crouching, being stiff or rigid, abdomen tucked, head down, recumbent Change in personality such as being docile or aggressive, anxious, dull, depressed, reclusive Restlessness; frequent changing of positions such as repeatedly lying down and getting up (large domestic species) or pacing Decreased activity, reluctance to move or other changes in locomotion
2. Pain assessment levels Level of pain Description 1 Deep palpation of the surgical site and immediate surrounding tissue provokes a response. 2 Deep palpation of the surgical site and immediate surrounding tissue provokes a response but a similar response can be seen in the contra-lateral limb, suggesting a hyperesthetic and/or a hyperreflexive state. 3 Deep palpation of the surgical site and immediate surrounding tissue provokes a response but a similar response much greater than a single stimulus on a nonsurgical part of the body. Probably indicative of some pain and appropriate analgesics should be administered. 4 Deep palpation of the surgical site and immediate surrounding tissue provokes a response much greater than a single stimulus on a non-surgical part of the body and accompanied by vocalization in an otherwise quiet patient. Requires analgesia.