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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Bilious Vomiting Syndrome in Dogs

February 09, 2012 / (11) comments


One of the frustrations associated with being a veterinarian is the all-too-common request for free advice. My problem isn’t really with the "free" aspect of it; I just know that chances are I’m not going to be able to tell you anything definitive about your pet’s condition based solely on a description of her symptoms.

 

So, if you just have a basic question (e.g., should I get my new dog tested for heartworms before putting him on prevention?), fire away. But, if your question is more along the lines of, "My cat has symptoms X, Y and Z; what could be wrong with her?" know that my answer will almost always be something like, "The list of possibilities is pretty long. I’d need to see her and maybe run some diagnostic tests before I can narrow them down for you."

Of course, there are always exceptions to the rule. A friend called me a while back asking what could be wrong with her beagle that woke up every morning and promptly vomited foam and bile. Petunia was otherwise completely normal: eating well, maintaining her weight, normal stools, no abdominal pain, bright, active, etc., etc. "Aha," I thought, "finally a question I can answer."

These symptoms, vomiting on an empty stomach when absolutely everything else is normal, are classic for a condition in dogs called bilious vomiting syndrome. We don’t know the exact cause — maybe stomach acid or other digestive secretions that collect in an empty stomach are irritating — but the solution is simple: feed the dog more frequently. Not more food, which would lead to weight gain, just more frequently.

In Petunia’s case, since she was vomiting first thing in the morning, I told my friend to offer her a small meal right before bedtime. That did the trick; no more vomiting. My recommendation had the additional benefit of having absolutely no possibility of doing any harm — one of my requirements for coming up with an armchair diagnosis and treatment plan.

Even though I was pretty confident that I knew what was going on with Petunia, I still had to couch my answer by adding, "If that doesn’t do the trick, make sure you get her in for a physical." Always better to be safe than sorry, right?

 

 

Dr. Jennifer Coates

 

 

Image: WilleeCole / via Shutterstock

 

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COMMENTS (11)
1
Bilious Vomiting Syndrome
by on 02/09/2012 06:45am

We had a dog that did this and it was the start of Imflammatory Bowel Disease. SO I hope that people do not ignore this and think nothing is wrong. After many vets and many incorrect diagnosis, we finally had him scoped only to find out he had two very severe types of inflammatory bowel diseases. By the time we got a correct disgnosis, it was too late to save him. Even though we got him a very agressive treatment and spent thousands of dollars to try to get him better. So sometimes vomiting on an empty stomach is more than just Bilious Vomiting Syndrome!

by on 02/10/2012 11:15pm

I am sorry to read about your dog's serious IBD. My dog has recently been diagnosed with mild IBD and is responding fairly well to a reduction in medications. I thought he had bilious vomiting syndrome and tried more frequent feedings with no success.

by on 02/11/2012 08:57am

Stay on top of this, because a dog who has been diagnosed with IBD is never cured, but the disease is treatable if caught in time. I just hope that people don't take lightly to a dog throwing up and think it is just bilious vomiting syndrome. We had out dog diagnosed from upset stomach, parasites, HG and then finally IBD. We took him to UC Davis Veterninary Medical Hospital for scoping and found out he had two types. There are 4 types and a the dog needs to scoped and biospy to find the correct one for the proper treatment. Unfortunately our dog disease was so bad that he didn't respond to any of the treatments. It is a VERY BAD DISEASE.

2
Litter Box Problems
by on 02/09/2012 08:03am

My WInston started having litter box problems after years of no problems.

That was the only symptom, yet I just "knew" it wasn't behavioral.

It took five trips to the vet (yes, five) to find he had lymphocytic lymphoma.

3
Thank-you Doctor Coates
by on 02/09/2012 01:00pm

My Pet-Kids as they get older, Vomit, when thier Allergys act-up....than they feel better. I'll say this at times I've ask others for advice, Now with the inter-net. Helps me,
with simple questions. For the major-ones off to our Doctor.

4
Cats too?
by on 02/09/2012 09:46pm

So what about bilious vomiting syndrome in cats?

I have a cat whose vomiting on an empty stomach has been getting worse and worse. Also, she's been getting pickier and pickier, oddly, willing only to eat ever lower quality food, specifically horrible fishy concoctions or (grain free) dry which i HATE to feed and I know how bad it is.

Walks entirely away from the high quality canned stuff I'm used to feeding.

She started a vomiting jag that got so bad she was vomiting bloody bile.

She had a similar flareup last year and we ran EVERY test. This cat has had an echocardiagram for rapid breathing, an ultrasound, and bloodwork more frequently than every 6 mos. My vet has found nothing except low Folate.

???????

I now must feed this cat no less frequently than every 6 hours (which means getting up at like, 5:30 to feed her and go back to bed for another hour and a half) or else the vomiting jag starts, and with the vomiting jag comes increased innapetence, which becomes a viscious cycle.

:(

I do worry about lymphoma and she hasn't had an ultrasound in a year when the first flareup happened, but my vet isn't recommending another one because her bloodwork is beautiful and she has actually gained some weight.

Do cats get bilious vomiting syndrome?

by on 02/10/2012 09:00am

I've not seen it in cats. Re. your cat, if she were my patient I'd be recommending gastrointestinal biopsies if she hasn't had any performed in her previous work-ups.

5
bilious vomiting
by on 02/10/2012 11:46am

Had a small dog that started that every morning. Not much, but consistent. Switch dog food brand and it stopped immediately.

6
2 of my cats do this, too
by on 02/10/2012 02:02pm

I feed my cats every 12 hours and I try to be on schedule. But if I'm very late with breakfast, 2 of my 6 cats will both vomit up a couple teaspoons worth of bile. They are two sisters, about 12 y.o. None of my other cats do this.

They've both been seen by my trusted vet for this issue and there's nothing else wrong with them. Weird, but so cat-like!

7
Bilious Vomiting Syndrome
by on 02/11/2012 04:34pm

Self pet remedy won't help in this case. I'd better take my dog to the vet.

8
Bilious vomiting syndrome
by on 02/12/2012 02:52am

When moving, both my cats, (13, I retired from rescue)and my Russel's hound vomited on empty stomachs, till they could get back to a grass lawn, with other little plants, They eat this plant life every few days, apparently on empty stomachs, and vomit it up, and are OK after that. I live in the Philippines, but when i lived int the US I noted the same thing. The liquid vomited is not much, and it always has grass or plant life in it. Cats of course also vomit hair balls. The cats all eat commercial cat food, the Russel switched from commercial to boiled chicken only after a tick bite nearly killed him, as predicted by our vet. The cats get food set out twice a day, they eat what they want when they want to, and all are healthy and within weight profile

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About fully vetted

Jennifer Coates, DVM

Photo of Dr Coates

Image credit: Jim Piraino

...graduated with honors from the Virginia-Maryland Regional College of Veterinary Medicine in 1999. In the years since, she has practiced veterinary medicine in Virginia, Wyoming, and Colorado. She is the author of several books about veterinary medicine and animal care, including the Dictionary of Veterinary Terms: Vet-Speak Deciphered for the Non-Veterinarian. Dr. Coates also writes short stories that focus on the strength and importance of the human-animal bond, and freelance articles relating to a variety of animal care and veterinary topics. Dr. Coates lives in Fort Collins, Colorado with her husband, daughter, and various species of pets.

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