Last edited Nov.07
TOXICITY
CLINICAL OBSERVATION RECORD
Date (day 1) : Investigator:
Study ID:
Mouse Strain/sex:
Drug:
Dose: Route of Admin.! Schedule:
Other:
Group #:
Animal ID: Markings
Date:Experiment Day:
Nothing Abnormal / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0
Body Weight (g)
6-10% Loss / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
11-15% Loss / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2
16-20% Loss / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3
Hydration
Dry Eyes / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Sunken Eyes / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2
Skin Tenting (1sec) / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2
Behavioral Observation
Abnormal Gait / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Shaking (occasionally) / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2
Shaking (constantly) / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5
Signs of Weakness
Mild Scruffed fur / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Marked Scruffed fur / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2
Hunched (while sitting) / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2
Hunched (sit and walk) / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3
Paralysis / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5
Labored Breathing / 4 / 4 / 4 / 4 / 4 / 4 / 4 / 4 / 4 / 4 / 4 / 4
Lethargy
Slow moving / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2
Slow when stimulated / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3 / 3
No response when stimulated / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5 / 5
Additional Observations / / / / / / / / / / / /
Total Score2:
'See additional observations score sheet for # and Letter notation
2Any mouse with a score of5 in a single category (other than wt. loss) or overall score of 10 is euthanized. Performed by:
Any mouse with weight loss 20%is euthanized Date:
Additional Observations Score
H -head tilt 3
T -tail ulceration or necrosis 2-5
R-skin rash 2-5
ED-edema 3