What is Bilious Vomiting Syndrome?
Bile aids in the digestion process by breaking down lipids (fats). Bile cells continually produce bile which travels down to the duodenum, the first part of the small intestine, or it can enter the gallbladder, where it is stored. It is a yellowish green bitter substance, which contains water, bile acids, cholesterol, fatty acids and electrolytes. Bile acids are also called bile salts.
When the dog’s stomach is empty there is nothing to absorb the stomach acids and bile. This causes nausea and bilious vomiting. This condition is a bit challenging to treat because an empty stomach causes nausea and vomiting, which causes the dog not to want to eat. Not eating means an empty stomach, which causes nausea and vomiting. It becomes an ongoing cycle.
Bilious vomiting syndrome may be more common in dogs with giardiasis (parasite), food allergies or inflammatory bowel disease (IBD).
The continual vomiting can cause a dog to dehydrate. Puppies especially can become dehydrated very quickly. If your dog is showing symptoms of bilious vomiting, he should be seen by a veterinarian.
Bilious vomiting syndrome (BVS) in dogs is vomiting due to bile build-up irritating the stomach lining. Bilious vomiting in dogs usually occurs in the morning or late at night, when the dog’s stomach is empty.
Symptoms of Bilious Vomiting Syndrome in Dogs
Symptoms may include:
- Frothy yellow vomit
- Vomiting usually occurring in the morning or late at night
- Depression
- Lethargy
- Drooling
- Licking his lips
- Lack of appetite
- Concentrated urine, pale gums, sunken eyes and loss of skin elasticity are signs of dehydration
Causes of Bilious Vomiting Syndrome in Dogs
- Accumulated bile in the small intestine can leak into the stomach
- Bile is a very high alkaline substance, which is irritating to the stomach lining
- The empty stomach cannot absorb the bile; the dog then gets nauseated and bilious vomiting occurs
- Bilious vomiting is more common in dogs with the parasite Giardia
- Bilious vomiting syndrome is common in dogs with inflammatory bowel disease
Diagnosis of Bilious Vomiting Syndrome in Dogs
The attending veterinarian will want to go over your canine’s medical history. Advise the doctor in detail what symptoms you have observed, expanding on information such as when the vomiting usually occurs.
- Is it a daily event?
- Does the bilious vomiting happen once and then cease, or continue for some time?
The veterinarian may want to know what the dog’s current diet is and how often is he fed.
The veterinarian will then perform a physical examination on the patient. This may include taking your dog’s temperature, weight, pulse and blood pressure. The doctor may palpate the patient’s stomach and listen to his heart and lungs. He may also check the dog’s skin elasticity, gums, and eye reflex response.
The veterinarian may suggest abdominal x-rays, an ultrasound, a fecal exam and a urinalysis. A complete blood count and a serum chemistry panel may be taken. A complete blood count can help determine the dog’s overall health. The serum chemistry panel can evaluate organ function. Bile vomiting can be caused by several conditions; the veterinarian will want to rule-out other health conditions or diseases (e.g. stomach obstruction, pancreatitis, and parasites).
Treatment of Bilious Vomiting Syndrome in Dogs
If your dog is dehydrated, the veterinarian will start an IV to administer replacement fluids. The fluid therapy may be given over 24 to 48 hours depending on how severe the dehydration is. This means the patient will need to remain hospitalized and will receive intensive care.
Dogs diagnosed with bilious vomiting will be prescribed an H2 blocker such as Tagamet, Pepcid or Zantac. H2 blockers reduce the amount of stomach acids being produced. The doctor may prescribe prokinetic agents to improve gastric motility, which may help with acid reflux. Sucralfate may be recommended short term to help coat the irritated/inflamed stomach and esophagus.
The patient will need smaller meals, to be fed more frequently. A healthy snack before bed may also help your dog not to vomit in the morning. Canines diagnosed with inflammatory bowel disease will need to be on a high-quality diet free of any of their allergens. Hydrolysed hypoallergenic diets may be recommended. A detailed medical treatment plan will be prepared by the veterinarian team.
Dogs diagnosed with Giardia will be treated with anti-parasitic medication such as fenbendazole and/or metronidazole. Your dog will need to be bathed with a medicated shampoo to eliminate any parasitic cysts (eggs) from his fur. Your pet’s bowls, bedding, and toys should be washed in very hot water. It is important to also clean and disinfect the flooring, carpets and upholstery. Hard surfaces should be disinfected with a diluted bleach solution. Pet’s should be re-tested after two weeks.
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Recovery of Bilious Vomiting Syndrome in Dogs
Recovery of bilious vomiting syndrome, once treated for the specific cause, has a good prognosis. It is important to follow the treatment plan prepared by your veterinarian for your pet’s specific situation. Follow up visits will be required to monitor his progress.
Bilious Vomiting Syndrome Questions and Advice from Veterinary Professionals
Belgian Malinois
Five Years
9 found this helpful
9 found this helpful
My pet has the following symptoms:
Vomiting Yellow Foam
Buster normally vomits yellow form 1-3 times a day. He doesnt act differently or anything. He is super hyper.
Dec. 26, 2020
Answered by Dr. Linda S. MVB MRCVS
9 Recommendations
Thank you for your question.
Frequent vomiting is not normal and will have an underlying cause.
We would consider IBD, food allergies, food sensitivities, parasites, infections bilious vomiting syndrome etc.
A vet check would be best and they may run some tests such as a blood test or abdominal scan.
Be sure he is up to date with a good quality parasite prevention.
Consider changing to a hypoallergenic or sensitivity diet, to see if this may help.
Dec. 26, 2020
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Yorkshire Terrier
Seven Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Regularly Vomiting Once A Week
Why would my dog eat well play and act like healthy dog for 4-6 days then suddenly goes off food
Sept. 25, 2020
Answered by Dr. Michele K. DVM
0 Recommendations
Thank you for your question. I apologize for the delay, this venue is not set up for urgent emails.
I hope that your pet is okay. If they are still having any problems, It would be best to have your pet seen by a veterinarian, as they can examine them, see what might be going on, and get any testing or treatment taken care of that might be needed.
Oct. 20, 2020
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Pit Bull mux
Odin
1 Year
17 found this helpful
17 found this helpful
My pet has the following symptoms:
Vomiting
I have had my rescued pup since he was 3 months old. He was diagnosed with Parvo and received treatment from it. Since then the only issue I seem to have is that my dog has had issues in the past with throwing up bile on an empty stomach. After some time without eating, he is typically back on his feet eating. Yesterday he started to throw up bile to no end. He is still throwing up nothing but bile with the episodes happening between 1 hour to 3 hours. He is an otherwise healthy dog who is up to date with all his shots and preventative vaccines. He just had a visit to the vet due to allergies and was prescribed aboquel but that was it. Even while being sick he is eager eat ice and sip some water and is fully alert. No signs of lethargy. I am aware that he will need a visit, but I was just in there and he was considered very healthy. Is there anything that can help with this bilious vomiting.
Aug. 1, 2018
17 Recommendations
Just because a Veterinarian gives a clean bill of health one day doesn’t mean a few days later a disease or condition cannot develop; the vomiting of bile may be caused by a various of different conditions but is normally associated with an empty stomach. One way to try to resolve this is to feed a bland diet of boiled chicken and rice in small regular meals so that the stomach isn’t irritated by the food and that the stomach isn’t left empty for hours; some conditions including infections, parasites, foreign objects, inflammatory bowel disease, pancreatitis among others may cause similar symptoms. See how things go with the bland diet (feed four to six times per day) and visit your Veterinarian if there is no improvement. Regards Dr Callum Turner DVM
Aug. 2, 2018
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Poodle mix
Wilbur
3 Years
8 found this helpful
8 found this helpful
Hi! Our dog,Wilbur, was a rescue from a horder. After 2 years of vbs, I am at my wits end! We have seen four vets, and a behavior therapist! He is a very picky eater, and we have tries everything from prilosec, to pepcid, to prosac, multiple probiotics, ect. to help him. And if he does not eat every 5-6 hours, he throws up. I can't board him because of his severe seperation anxiety, because he won't eat while away from me. We need to perhaps get him on a strict diet, he is not over or under weight, but we need to do something! His overall health is excellent, he even has his OWN therapy dog!! Which has helped somewhat. He has had numerous tests, bloodwork, stool samples, x-rays, ect. which have all came back negative. Any advice?
July 28, 2018
8 Recommendations
These cases can be difficult to manage and it is very easy to throw the whole gastrointestinal tract off by missing a feeding time or something different being consumed; there is no magic solution unfortunately, just a trial and error process to keep the vomiting and anxiety under control as best as possible. Feeding a high quality restricted ingredient diet may help but then there may be issues with palatability or other issues; as I mentioned it is just a case of balancing everything through trial and error as well as keeping the feeding schedule. Regards Dr Callum Turner DVM
July 29, 2018
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Greyhound
Ellis
8 Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Bile Emesis
Bile Emesis Anorexia
My greyhound has been anorexic for over a month. We have tried flatly, steroids, Remeron and now Entyce. He is now refusing all food - canned, chicken, ground beef, tuna, freshpet,and dog biscuits. His lab work x2 has all come back normal and has negative xrays. He is now vomiting bile but no diarrhea. He has lost 20 lbs. He is ten pounds under race weight. HELP
July 1, 2018
0 Recommendations
If Ellis isn’t eating, it is understandable that he is vomiting bile due to an empty stomach; it can be difficult to determine a specific cause for a loss of appetite which may be caused by many different conditions, the clear blood tests and x-rays just make it more difficult to diagnose. It is difficult to think of what else to try since it is important to diagnose the underlying cause. Regards Dr Callum Turner DVM
July 2, 2018
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Australian Shepherd
Luna
1 Year
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Bile Vomiting
Frequent Vomiting W/ Empty Stomach
General Depression After Vomiting
Low Appetite After Vomiting
First, a bit about me: I've had dogs my entire life. My mother used to breed dogs, and we used to foster, rescue, and rehab dogs too. I've had a LOT of experience with dogs and a variety of medical and non-medical problems throughout my life. I once wanted to be a vet (but the price of school wasn't something I could afford).
I just wanted to share my experience with my Australian Shepherd, Luna. I got Luna at 9 weeks old. I also acquired her sister, Willow, at the same time. When Luna was very small, she vomited for no reason. There was so much that it genuinely scared me. She kept vomiting, 4, 5, 6 times in a batch. We took her to the vet. She had nothing wrong with her. We were sent home with Famotidine. After that, she continued to vomit - on and off. We were able to trace it to her refusing to eat late at night and or early in the morning, so we began to try to offer her anything we could to get her to eat. Ritz, saltines, and bread ended up being the go to options. On days she was really bad, we would give her the famotidine from that first visit and Gatorade to keep her from getting dehydrated (or low in electrolytes). At this point, I assumed (and told my husband as much) that I thought she had "some kind of reflux issue." I didn't know the exact name of it, but I knew it was a thing dogs could get.
Fast forward awhile: Luna is now a year old, and we still have the vomiting issue. This past week, she was particularly bad and not vomiting only on an empty stomach. So we took her to the vet again. Her new bout of vomiting was diagnosed as her deciding that rock consumption might help (it will pass on its' own) and I got an official confirmation on what I'd suspected for many months now: Luna has Bilious Vomiting Syndrome.
Her award? A shot to stop the current bout due to the rock, and Omeprazole to manage the Syndrome.
Luna's case is severe enough that she will likely never manage to go off the medicine permanently. This is partly due to the fact that, unlike her sister who will eat anything and everything, Luna is significantly more finicky. She will only eat as much as she requires and only when she requires it. Unfortunately, her choices don't take into account that her fussiness is the cause of her vomiting. Luna will even refuse treats and most human food when she has decided she is full.
She may, however, be able to graduate to seasonal treatment only in the future. Luna and Willow both go to agility and, exempting winter, this runs year round. Agility increases her energy burn, so she willingly eats more to make up for the difference. This is part of the reason that the issue went undiagnosed for so long. It took us getting to-and-through winter for it to kick into overdrive and cause an almost-every-day-problem.
After agility, Luna also gets a JR frosty from Wendy's, so this may have also help to disguise the problem.
