Jacob and Jeffrey’s Journey of Dysphagia

One of the classic stories about dog rabies is fear of water. Is this true? This lesson will help you define dysphagia and learn how it can apply to rabies. You will be able to explain what parts and processes involving the GI tract are impacted by dysphagia and you will be able to explain why dogs with rabies foam at the mouth.

Lesson

An epic battle between two dogs breaks out. Jeffrey had enough of Herold not acting like himself. Jeffery decides to cut his losses and walk away from the fight, but as he walks away, Herold gives him one last bite in the butt. Jeffrey yelps and runs away, and as he looks back one last time, he sees excessive drool dripping from Herold’s mouth, almost like he is foaming at the mouth. He walks away wondering what this could mean. Meanwhile, we zoom into the point of the bite on his butt. 

We are now following the journey of Jacob, a lowly ol’ rabies virus whose world has turned upside down as he has been deposited into this strange new environment. Jacob takes a moment to look around and is relieved to see hundreds of his comrades he was familiar with from Herold. He sighs a breath of relief. Jacob begins to take charge. He stands up on a taller shred of muscle where everyone can see him. “Hello comrades! It is time to begin our new journey here! We have a long road ahead of us, but I believe we can do it! Who’s with me?!” The crowd cheers. Jacob begins to lead the army to the nearest nerve. He then starts en route up the nerve towards Jeffery’s spinal cord. 

It has now been a week and Jacob and his army have made it to the spinal cord. They take a moment to collect themselves. Jacob stares down the path along the spinal cord ahead of them. It’s going to be a long journey. They start down the spinal cord first thing in the morning, but Jacob quickly begins to notice that his comrades are being picked off one by one the further along they go. Could it be? Could this dog, Jeffrey, be vaccinated for rabies? Jacob had only heard of it as an urban legend, but no one he ever knew lived to tell the tale. “No,” he tells himself. “We would have already been wiped out by now, right?” Fear crept into his mind, but he still trudged ahead. “No sense in turning back now,” he thought.

It has been 6 months since we last heard from Jacob. Things are not looking good. Jacob’s army has dwindled down to half the size it used to be, but Jeffery’s immune system is trying to do the best it can with what it has, but since Jeffrey had not been vaccinated for Rabies since he was a pup, it was no match for Jacob’s perseverance. Jacob and his team pushed on as they now are reaching the cervical region of the spinal cord. “We’re so close I can taste it,” Jacob says to himself. But just as he gets excited, an army of immune cells ambush them and now they’re full on under attack. Jacob and his army manage to defeat them, but he’s left with only 20 men to spare.

It has been 3 more months since we last saw Jacob. Him and his 10 remaining men are finally reaching the brain. Jacob cries tears of joy at the sight of the brain and the thought of the long journey they’ve had. Him and his men have a brief moment of celebration, but they don’t waste time in getting to work. “Alright boys, now the moment we’ve all been waiting for,” cheers Jacob.

Jacob and his men waste no time making themselves at home. First matter of business is getting to work on building a new army. Jacob hyperactivates Jeffrey’s salivary glands, causing excessive salivation and foaming at his mouth. Jeffrey begins to swallow more to avoid drooling everywhere, but this poses a problem for Jacob as he is trying to build his army in the saliva. He pauses for a moment to think. “Ah! I know what to do!” He exclaims. Jacob walks his way over to a different center of the brain that controls the muscles of the esophagus. “That should do it!” Says Jacob. Suddenly, Jeffrey finds himself in excruciating pain. His first instinct is to try and find water, something to wash this feeling away, but the moment he drinks water, the pain increases tenfold. Jeffrey is yelping and screaming. “The water must have done it,” he thinks to himself.

As the next few days progress, Jeffrey’s condition is declining rapidly. He’s drooling everywhere, scared to drink, scared to eat, and is getting worse by the day. Because Jeffrey is not eating, his stomach has no proteins to break down and his small intestine has no carbohydrates or fats to digest. He can’t absorb any nutrients in his small intestine to fuel his body because he can’t eat any food. He isn’t drinking either, which means his small and large intestine can’t absorb any water that his body needs, especially since he is drooling more than normal. Now that Jeffrey is unable to eat and absorb nutrients, his body is wasting away due to starvation and dehydration. Since nothing has progressed into his stomach for the last few days, there is no longer anything filling Jeffrey’s stomach, or any of his GI tract for that matter.

Activities

Try this sorting game to help solidify your understanding! Sort the text boxes into their correct category of whether or not they are associated with dysphagia.

Assessment

Try this assessment on your own first, then the class will go over it together!

Further exploration

Here are other fun links where you can learn more about rabies and dysphagia in dogs!

Why rabies causes hydrophobia in dogs

The Effects of Nutrition on the Gastrointestinal Microbiome of Cats and Dogs: Impact on Health and Disease – PMC.

Dysphagia (Difficulty Swallowing) > Fact Sheets > Yale Medicine.