MULTIDIMENTIONAL OBSERVATION AND SCORE WORKSHEET
EXPERIMENT NO. : _________________________
ROUTE OF ADMINISTRATION: ____________________________________________________
TIME GIVEN: _______________________________________
ANIMAL: ____________
FASTED: _____________
GROUP NO: ___________________________________________________________________
LOG BOOK NO: _____________________________________
DRUG: ____________________________________
DATE STARTED: ________________________________________________________________
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DUE DATE: ____________________________________________________________________
NORMAL SCORE
Mice #
Time
Sex
Wt. (g)
Control MS
Sample
Dosage (mg) Control F8
CNS Stimulation
Eyes
Ears,
Oral,
Mucosa
General Observation
Body
Weight
Subjective Observation
Motor Activity
Ataxia
Loss righting Reflex
Analgesia
Anesthesia
Resp. Pate
Resp. Depth
Loss Corneal Reflex
Loss pinnal Reflex
Paralysis: foreleg
Paralysis: Hind legs
Paralysis: Head
Screen Grip H.L. Loss
Screen Grip F.L. Loss
Motor Activity
Fine body Tremors
Coarse body Tremors
Fasciculations
Convulsions
Resp. Rate
Resp. Depth
Enophthalmos
Exophthalmos
Palpebralptosis
Pupil Size mm.
Nystagmus
Lacrimation
"Bloody Tears"
Blanching
Hypereamia
Cyanosis
salivation
Tail Erection
Pilomotor Erection
Micturition
Priapism(Male)
Colpectasis(Female)
Robichaud test
Circling Motion
Tail Lashing
Abdominal Gripping
Rectal Temp.
days
After
days
After
days
After
Head tap: Passive
Fearful
Aggressive
Body Touch: Passive
Fearful
Aggressive
Catalepsy
Excess Curiosity
stereotypy (note)
PARAMETERS
CNS Depression