Bilious Vomiting Syndrome in Dogs

Bilious Vomiting Syndrome - Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost

Most common symptoms

Anemia / Concave Chest / Depression / Licking / Seizures / Vomiting

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Rated as moderate conditon

10 Veterinary Answers

Most common symptoms

Anemia / Concave Chest / Depression / Licking / Seizures / Vomiting

Bilious Vomiting Syndrome - Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost

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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) 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 (stomach obstruction, pancreatitis, and parasites).

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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 diet free of grains, fillers or by-products. A homemade diet 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.

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.

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Bilious Vomiting Syndrome Questions and Advice from Veterinary Professionals

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Odin

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Pit Bull mux

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1 Year

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Moderate severity

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0 found helpful

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Moderate severity

Has 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

Odin's Owner

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3320 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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Wilbur

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Poodle mix

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3 Years

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Fair severity

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0 found helpful

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Fair severity

Has Symptoms

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

Wilbur's Owner

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3320 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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Ellis

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Greyhound

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8 Years

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Critical severity

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0 found helpful

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Critical severity

Has 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

Ellis' Owner

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3320 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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Ronnie

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Rough Collie

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5 Years

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Mild severity

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Mild severity

Has Symptoms

Vomiting In The Morning

I have a rough collie who is 5 years old. It's been almost a year since he started vomiting early in the mornings. We have tried to split his meals and it will look like this: first meal around 7 am, snack at nook, snack around 5, last meal around 7. Some days he'll be fine but recently he started vomiting again. He's had many blood test and they all look fine. He doesn't have diarrhea and it is, in general, a pretty healthy good with good levels of energy. He's not taking any medication so I'd appreciate any suggestions for him. He eats Nutranuggets light and sometimes we'll add cooked chicken breast. Once in while he'll eat fruits like watermelon, apples, and melon. I'd appreciate any help. Thanks.

Feb. 26, 2018

Ronnie's Owner

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3320 Recommendations

In cases like this it is important to ensure the eating habits are managed with small frequent meals which you are currently giving to him, you may also want to consider giving a different dog food which may be better on the stomach; try to cut out the extras and keep a gastrointestinal sensitive kibble. I cannot really add any more than your Veterinarian has already done if he is otherwise healthy. Regards Dr Callum Turner DVM

Feb. 26, 2018

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Kira

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Rough Collie

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3 Years

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Moderate severity

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Moderate severity

Has Symptoms

Bvs

Hi,my 3 yr old rough collie has BVS since a puppy - at first she also often had diarrea which was solved switching to Hil's i/d.But the early morning sickness has not been resolved even with giving her smaller meals more often together with antiacid medication.Otherwise she is perfectly fine healthwise. I read of someone using Fortiflora did the trick but not having problems with diarrea could it be of help or just a waste of time or worst of all cause problems with her poops. Thanks in advance for any advice

Jan. 17, 2018

Kira's Owner

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Dr. Michele K. DVM

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1611 Recommendations

Thank you for your email. I'm sorry that Kira is having these problems. Fortiflora is a nice probiotic product and can help with a number of conditions - it shouldn't cause any problems with her stool. It may not help, but it shouldn't hurt. Since I haven't examined her, it would be best to check with your veterinarian before starting it, however. I hope things go well for her.

Jan. 17, 2018

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Luna

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Australian Shepherd

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1 Year

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Serious severity

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0 found helpful

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Serious severity

Has 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.

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Sansa

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Golden Retriever

dog-age-icon

3 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Vomiting Bile
Vomiting Bile Depression

My dog has never been a normal dog. Even when she was a puppy she has never enjoyed food. We think she came from a puppy mill, but we aren’t 100% sure. She has always had trouble eating and would go a few days without eating at all. When she was 1 years old, we got another dog because we thought it might help to have a friend for her. When she was about 2 years old, my husband got deployed for a year. I moved her across the country to live with my parents. I was also pregnant at the time. Her eating habits got even worse... her anxiety was awful too. She would go 3 days without eating and would puke bile. I have seen many different vets and had blood work done for her. They offered no advice. I was determined to get her to gain some weight. I stopped working after I had my baby and I had more time to try to Get her to eat. I sat with her two times a day for over an hour to get her to eat. She finally would eat, but it took a really long time. I did this for 8 months and now she is 15 pounds heavier.... I was getting very tired of sitting with her for two hours a day.. so I started to cook her own meals. She loved them but then got tired of them and she won’t eat what I cook her anymore. She’s been on Prozac for 3 months now and it doesn’t seem to be working. My husband returned home from deployment and she won’t eat hardly at all now. Sometimes I can get her to eat wet cat food.. but that’s about it. I’m at my wits end. She won’t even eat peanut butter ... or treats most of the time. She sits around all depressed. She’s mostly sad and depressed if I ask her to eat. She loves to go on walks and to the dog park. She’s kind of an anxious dog. She’s always been that way. She’s never been good driven EVER. I think it’s time to rehome her. But we love her!!

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Olive

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Jindo

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11 Months

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Mild severity

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pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Mild severity

Has Symptoms

Vomiting Bile

My 11 month old Jindo is the most energetic, happy pup in the world. Yet for some reason she throws up bile 1-2 times a week. I'm thinking it may be due to her diet? She eats salmon based kibble and I feed her around 0700 and again at 1700. Should I make any changes to this? She has good poops, and like I said is very active and does not seem bothered by this at all. Thank you!

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Harley

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Staffordshire Bull Terrier

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18 Months

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Mild severity

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Mild severity

Has Symptoms

Throwing Up Bile During The Night

I have an 18 month old Staffy who had a very bad case of diarrhoea a couple of months ago which resolved itself. It started with her throwing up bile during the night. She has now started throwing up bile again and her bowels are loose but no diarrhoea. She is off her food in the morning but then picks up as the day goes on and is then starving. I give her three small meals each day and some dry biscuits before putting her down. Could this be the same illness or could she have some parasite or virus?

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Poochie

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Mix breed of labrador and japanese spitz

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8 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Mild severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Mild severity

Has Symptoms

Vomiting

My dog is a mix breed of several dog breeds. She has been vomiting every night and the color is yellow, he doesn't want to eat even if i tried to feed her she only drinks water and doesnt take any other food or liquid just plain water. She was energetic before right she is not. One night i tried to touch her belly and she started to whine like she was saying that her tummy is aching.

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