Jacob and Jeffrey’s Journey of Dysphagia

Instructional Guide

Learners will explore how rabies can cause difficulty swallowing (dysphagia) in dogs and how components of the gastrointestinal tract and concepts of digestion and nutrient absorption are affected.

Intended Grade Level

This lesson is intended for students in 9th – 12th grade.

Students should be familiar with the general anatomy of the GI system, especially the oral cavity and esophagus. They should also be familiar with the terms prehension, mastication, and deglutition, and have an idea of the normal path of ingesta. Students should have a general idea that rabies is a virus that affects the nervous system.

Learning objectives

• Students will understand the medical definition for dysphagia
• Students will be able to explain how the GI tract is impacted by dysphagia
• Students will be able to explain why dogs with rabies foam at the mouth
• Students will understand why dysphagia occurs due to rabies

Lesson Format

This lesson can be done individually or in a group.

• First student(s) will read the story of Jeffrey and Jacob either individually or as a group. (5-10 minutes)
• Student(s) will then work individually or together to answer the story’s follow-up questions and complete the sorting game. (20 minutes)
• The student(s’) learning will then be assessed through an “order the steps” activity. (20 minutes)

Lesson Background

Dysphagia is the medical term for difficulty swallowing. Dysphagia is one of the many neurological symptoms of the rabies virus along with restlessness, confusion, and uncontrolled excitability. The rabies virus also includes many non-neurological symptoms including fever, headache, increased saliva production, spasms of the throat and larynx muscles, and a general feeling of illness (malaise).

The Rabies virus causes dysphagia in the body in order to greatly increase the production and spread of the virus. The Rabies virus causes excessive salivation, but when the infected patient continues to swallow in retaliation, that greatly slows the spread of the virus, thus the virus has adapted to cause dysphagia (inability to swallow) to increase the production and spread of the virus.

Activities

Students will read the story of Jacob and Jeffrey’s Journey individually or take turns reading out loud in a group. After reading the entire story, students should answer the questions included after the story. Once the students have come up with their answers to the story, the answers should be reviewed as a group and the answers should be given by the instructor.

Once the class is done reviewing the post-reading questions, they can work individually or in small groups to complete the sorting game provided in the eBook. This gives them a chance to practice their new understanding of rabies and dysphagia and how it relates to the GI system before moving onto the assessment.

After the student(s) are done working through the sorting game provided, they can move on to the assessment, Order the Steps of Rabies and Dysphagia Leading to GI Concerns. Student(s) should work through the assessment individually first. After the student(s) have given the assessment their best attempt, the class should come together to discuss what they came up with. The instructor can guide them through the correct answers and assess any difficult sections, if any. If difficult to number steps are found, they should discuss as a class what the correct answer is and why this may be difficult to understand.

Common misconceptions and challenge points

Students may have misconceptions or confusion around certain concepts relating to rabies or dysphagia. Described below are some of the common confusion points or misconceptions students may encounter with this lesson:

• Rabies only effects the nervous system.
  • Correction: Rabies primarily infects the nervous system but can have a secondary effect on other systems such as the gastrointestinal system and the musculoskeletal system.
• Infection can only occur through a bite.
  • Correction: It can also be spread through bodily fluids – saliva, mucus, tears – when it comes into contact with the eyes, mouth, or an open wound.
• Why is it beneficial for rabies to discourage them from swallowing?
  • Rabies causes difficulty swallowing which disables the animal from being able to swallow saliva – this causes drooling. Because the virus lives in and is transmitted through saliva, causing the animal to not be able to swallow and then drool saliva allows the virus an easier chance to spread if it comes into contact with a wound (bite wound or other) or other direct opening into another animal.

Assessment

Students will work through a “put the steps in order” assessment. This assessment will start from the animal getting infected with rabies, proceed through the steps in which dysphagia begins to present, and how processes of digestion and absorption in parts of the GI tract are affected.

Further exploration

Include links or other activities that would support future veterinary students in their learning!

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.

Why does rabies cause hydrophobia?.