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What is Vomiting With Bile?

Bile is a yellow or green substance produced in a cat’s liver, which aids in digestion of food. Vomiting with bile, or bilious vomiting syndrome, in cats can be an alarming condition for both the feline and the worried owner.  Vomiting with bile may be especially difficult for an owner to recognize, given that animals are likely to clean up after themselves, unless you manage to catch your cat in the act of vomiting. This can make it difficult to determine exactly how long the condition has been occurring. It’s important to be aware of the signs and symptoms that can occur with bilious vomiting syndrome in order to determine when veterinary intervention is necessary.

Symptoms of Vomiting With Bile in Cats

Vomiting with bile typically occurs in the morning or early evening, when a cat’s stomach is empty, although it can also happen at any time. Here are the main symptoms to watch for:

  • Long term occasional vomiting
  • Vomiting that occurs with bile
  • Weight Loss
  • Disinterest in Food
  • Excessive Drooling


Vomiting can take many forms, and it’s important to distinguish the various types to know when a serious condition exists that warrants a trip to your local vet.

  • Regurgitation: In the wild, cats will eat small meals frequently, as food is available. When domesticated cats eat too much food at once, or eat too quickly, they can regurgitate their food after eating. 
  • Hairball: Hairballs are regurgitated or cleared from your cat’s throat in a manner that may seem similar to vomiting. They cat may heave for several moments attempting to clear the hairball and may also return stomach fluids or regurgitated food with the hairball due to the aggressive coughing.

Causes of Vomiting With Bile in Cats

In many cases, the exact cause of bilious vomiting syndrome, or vomiting with bile, is unknown. However, there are several conditions that can cause the condition and that should be ruled out by your veterinarian. Common causes may include:

  • Intestinal Inflammation
  • Irritation of the Stomach Lining
  • Improper Diet
  • Parasites
  • Infection
  • Liver Disease

Diagnosis of Vomiting With Bile in Cats

The first thing your veterinarian will do in order to diagnose the cause of vomiting is ask for your cat’s history concerning the condition. It is therefore important that you document the number of times, frequency and approximate start date of the vomiting. Additionally, you should collect a stool and urine sample if possible and supply your vet with the brand and specific recipe of any commercial cat food.

After reviewing the history of your cat, your vet may then opt to perform several diagnostic tests to rule out serious, life threatening conditions. These tests may include liver and kidney assessment via a urinalysis, a full blood profile including white blood cell count analysis, and a thorough physical exam. Your vet may also perform radiographic tests such as x-ray or ultrasound to examine motility of the contents of the stomach or any potential obstructions. It may take several days to over a week for the results of these tests to be returned to your vet.

Treatment of Vomiting With Bile in Cats

On some occasions, vomiting with bile in your cat will subside on its own. In cases where the syndrome is ongoing, there will be various courses of treatment depending on the underlying cause. In the event of food causes, your vet may prescribe an approved cat food formula for animals with problem stomachs or food sensitivities. They may also alter the amount or frequency of your cat’s meals. 

If food or diet alterations don’t alleviate your pet’s symptoms, the veterinarian may prescribe certain drugs such as antibiotics for infections or digestive affecting drugs to increase the ability of your pet to digest food or to reduce the amount of bile in the digestive system. Probiotics may also be prescribed to help reset the levels of good bacteria in your cat’s digestive system. 

Recovery of Vomiting With Bile in Cats

With appropriate treatment, the prognosis for your cat is very good after being diagnosed with vomiting with bile. Stomach conditions can take time to fully heal and your cat’s entire digestive system will often times need to reset and regrow important balances of good bacteria. In the case of prescription medicine, it will be important to complete the entire regimen in order to fully resolve the condition.

For food-based treatment, following the recommended course of meals and sticking with a consistent diet will almost immediately eliminate bilious vomiting syndrome. Alteration of the course of feeding, if followed, will provide lasting results. Most cats with this condition will respond well with maintained treatment, whether dietary or prescription based.

Vomiting With Bile Questions and Advice from Veterinary Professionals

3 Months
Moderate condition
1 found helpful
Moderate condition

I have two kittens that are about 3 months old. Since this morning one has been vomiting bile, and hasn't been as playful as normal. He has mainly been resting in one spot and sleeping, he'll still get up and move every once in awhile, mainly gets up go elsewhere and vomit. He gets annoyed and growls when the other kitten tries to play with him and he'll go to another room and lay there for awhile before he comes back and lays by us in the bedroom or on the couch. He won't eat or drink anything, but we were able to give him a little water earlier and he still threw up afterward. It's upsetting to see him not be himself. He's not as playful as usual, he has just been very quiet. The nearest vet can't see us until almost Tuesday and I'm not sure what else I can do to help him. It is possible he could have eaten something he shouldn't have, they both sometimes get into things During the night while we are asleep, I'm not 100% sure. Normally he eats and drinks just fine, is very playful and a big cuddler but all of a sudden he just lays there watching everyone around him, and can't seem to hold much down. The other kitten is perfectly fine, she has been eating, drinking and playing like normal.

Health Expert
Dr. Callum Turner, DVM
1712 Recommendations
It is important at a minimum to keep Benji hydrated, also speak with your Veterinarian’s Office and explain that Benji is not eating or drinking and don’t want to wait for Tuesday. Try to add a little Pedialyte to his water which may help him to drink, also separate the two cats so that Benji can rest without being disturbed. The causes may be due to an obstruction from a foreign body, especially if they like to get into different things, but other causes may be infection (even though the other cats is fine), parasites, other intestinal obstruction among other problems. I would push to see your Veterinarian earlier and push the lack of hydration and that his gums are sticky. Regards Dr Callum Turner DVM

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5 Years
Mild condition
0 found helpful
Mild condition

Hi there! My cat, Missy vomits almost every day. It began as hairballs with bile and is now bile and sometimes regurgitated food. She has had her bloods checked and all is fine. I've tried her on a hypoallergenic diet and she's not responding. Does she need X-ray's and contrast study to check her for obstructions? She is still providing a stool.

Health Expert
Dr. Callum Turner, DVM
1712 Recommendations
Obstructions are a possibility but I would look more into other possible causes if Missy has normal stool and isn’t showing any signs of pain; parasites, dietary issues, environmental irritants and other causes may be to blame. I would recommend you first visit your Veterinarian for a general examination to see if anything is picked up and allow your Veterinarian to guide you in the diagnostic process before jumping into contrast x-rays. Regards Dr Callum Turner DVM

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