Dd Form 1626 - Veterinary Necropsy Report Checklist And Guidelines Page 9
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12INSTRUCTIONS FOR COMPLETING DD FORM 1626
PURPOSE: DD Form 1626 is used to record necropsy results of military working dogs, but may be used for
other animals.
GENERAL: This form may be printed or photocopied without the instruction pages to minimize the length. DD
Form 1626 is available on the Army Electronic Library CD-Rom (EM 0001) and on the DoD web site at
SECTION I - ADMINISTRATIVE DATA
1. Blocks 1 through 7: Name and Address of the Reporting Veterinary Unit. Enter the rank, full name and title
of the contributing Veterinary Corps officer and the military unit to which assigned. Station address, telephone
and fax numbers, and e-mail address are all important information.
2. Blocks 8 through 16: Animal Identification.
3. Block 17: Euthanized (Yes or No). Specify the brand name or the active agent of the euthanasia product,
the amount given, and the site of intravenous administration.
4. Block 18: Cause of Death. Concisely state the medical reason(s) leading to the death of the animal. In the
case of euthanasia, state why the animal was euthanized.
5. Block 19: Name and Address of Unit Accountable for Animal. Enter the military unit that is accountable for
the MWD. Include the complete military unit designation and station address. (If the form is used for a privately
owned pet, the owner's information should be indicated in this block.)
6. Block 24: Materials Forwarded. List categories such as tissues, culture results and radiographs, gross
photographs, etc.
SECTION II - CLINICAL AND PATHOLOGICAL DATA
7. Block 25: Clinical Abstract. The clinical abstract should address the recent pertinent information regarding
this case, and previous significant medical history. Include illnesses, recent treatments, laboratory and radiologic
findings, surgeries, wounds, fractures, immunizations, working environment and recent TDY assignments.
Attach a copy of DD Form 1743, Death Certificate of a Military Dog; DD Form 1834, Military Working Dog
Service Record (Assignment History); and DD Form 2619, Master Problem List.
8. Block 26: Clinical Diagnoses. Concisely list significant clinical conditions relating to the death of this animal.
9. Block 27: Gross Necropsy Diagnoses. List all necropsy diagnoses (interpretations).
10. Block 30: Clinical Pathology Tests and Results. List tests and include a copy of the results.
SECTION III - GROSS FINDINGS
NECROPSY PROTOCOL
(Abstract of TB MED 283, Chapter 3)
INTRODUCTION (Para. 3-1)
a. Describe all abnormalities in detail. Use each block/diagram in this section for a systematic examination and
report. Enter "NGLR" (no gross lesions recognized) or an equivalent notation as appropriate.
b. Use physiologic saline to rinse tissues during the necropsy. Tissue specimens are sensitive to hydrostatic
and osmotic pressures. Rinsing with tap water will cause morphologic artifacts.
c. Organ weight data is optional. Collect when practicable.
d. Use the tissue checklist on Page 7.
EXTERNAL EXAM (Para. 3-2)
Carefully examine all external structures and surfaces and record the following: weight, nutritional condition,
state of rigidity, extent of post-mortem decomposition, and the condition of the haircoat, skin, mucous
membranes, eyes and body orifices. Describe tattoos, scars, wounds, cutaneous tumors, bony malformations,
discharges, etc.
EYES (Para. 3-3)
The eyes should be collected early in the necropsy. Clamp the eyelids together with tissue forceps (Allis
recommended). Use a scalpel to incise the eyelids around the orbit. With curved scissors, dissect the eyes from
the orbits by cutting extraocular muscles, connective tissue attachments and optic nerve. Examine and collect
lacrimal gland tissue. Check for eyelid and retrobulbar lesions. Eyelids should remain attached to the left eye for
identification; however, remove skeletal muscle from the surface of the sclera to facilitate fixation. Also, 0.2 -
0.5 ml of formalin may be injected directly into the vitreous chamber.
DD FORM 1626, OCT 2001
Page 9 of 12 Pages
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