Dogs are more likely to vomit in the early morning than in the evening. It is usually a very small amount of vomit that is yellowish or foamy and often a little bit thicker than usual. It’s more common in young dogs.
It’s been called empty-stomach, bile vomiting. It is medically known as “bilious vomiting syndrome”. The Latin billis (bile), and ous (having or full) are the sources of the word. Bile is a fluid produced by the liver. It is secreted to the upper portion of the small intestinale where it aids in digestion. Sometimes however, bile can back up into the stomach and cause inflammation of the stomach lining.
Although this sounds horrible, it is not the worst part of the term bilious vomit syndrome. The term syndrome is used by medical professionals to indicate that we don’t know what causes it. It’s much easier to treat and prevent a problem if we know the cause.
THEORETICAL CAUSE
Although the exact cause of bilious vomit syndrome is not known, veterinary medicine science does have some theories. One theory that is most commonly accepted is that the combination of decreased stomach motility, weak sphincter muscles between the stomach & small intestine allow bile from small intestine to backwash into the stomach. It is believed that bile is in the small intestinale and causes no problems there. It’s not allowed to be in the stomach. It can cause vomiting if it gets in the stomach.
AUTOTHER CAUSES OF VOMITING
However, vomiting can be a sign of many other conditions so it is important to rule them out before blaming bilious vomiting syndrome.
There are many differentials that can be used to treat chronic vomiting. While we will mention some of them here, this is not intended to be an exhaustive list.
Addison’s disease (underactive adrenal glands)CancerFood allergyGastric foreign bodiesGastritis/ulcers (can be secondary to things like nonsteroidal anti-inflammatory drugs [NSAIDs], stress, mast cell cancer)Helicobacter (bacteria thought to cause chronic vomiting)Hiatal hernia (stomach sneaks up into the chest)Inflammatory bowel disease (IBD)Intestinal parasitesPancreatitisPhysalopterosis (a stomach worm dogs can get from eating crickets, especially in the Midwest)Slow-moving intestinal foreign bodies
A physical exam is the first step in determining if there are any underlying conditions. A complete blood count, blood chemistry and blood chemistry may be useful.
To solve chronic, mysterious vomiting, other tests may be required, including fecal examination, chest/abdomen radiographs, abdomin ultrasound, biopsy, and endoscopy. Your dog may not require all of these tests depending on the preliminary results.
A diet trial using a hydrolyzed protein diet to rule out food allergies is recommended. A diet trial to rule out food allergy can be completed in as little as 10-14 days. However, diet trials to treat skin allergies take eight to twelve weeks.
Physaloptera is the stomach worm and it is not usually detected on routine fecal tests for parasites. Empiric treatment may be recommended if your doctor believes this to be a possibility. This is an aggressive and invasive test that can be used to diagnose a condition not high up on the doctor’s priority list.
It can also be difficult to diagnose an infection with theHelicobacter Pylori bacteria. Your veterinarian may recommend empiric treatment depending on the level of suspicion.
TREATMENT OF BILIOUS VOMING SYNDROME
A bedtime snack is something that most dogs love to have. Don’t give your dog extra calories if he is overweight. Instead, reserve a portion of his evening meal for bedtime and eat it. Photo Credits: Sanja Grujic/ Dreamstime.com
It’s now time to fix your dog’s bilious vomiting syndrome. In the event that only one step is necessary to resolve the problem, I recommend you change one thing at a given time. If you find that one step does not resolve the problem, then continue to add the next step. Sometimes, the solution may involve all of these steps.
Step 1: Give your dog a small dinner before bed. A biscuit may suffice for small dogs. It is believed that food in the stomach will increase gastric motility and buffer any bile that may sneak in. Step 2 can be added if that fails.
Step 2: Divide your dog’s daily food into small meals that are distributed throughout the day. This is done to encourage continuous motility in the stomach and prevent bile from leaking backwards. If these two steps don’t work, you can add Step 3.
Step 3: Add an acid reducer like omeprazole or Prilosec. Omeprazole should be taken twice daily, but you can take one dose at bedtime after week 1. Omeprazole can be used every night. Famotidine (also known as Pepcid) is also available. It kicks in quicker than omeprazole, but tolerance develops over time. This makes it less effective for chronic conditions like this.
Step 4: If these three options don’t work I add a prokinetic medication (which increases gastric motility). Your veterinarian might prescribe medications such as metoclopramide (Reglan), low-dose erythromycin, and cisapride. Metoclopramide can be prescribed for several other conditions and should be taken three times daily. One dose is usually sufficient for bilious vomiting syndrome.
If these four steps don’t work, you can add Step5.
Step 5: Talk to your veterinarian about adding a gastroprotectant, which may reduce the stomach’s sensitivity to bile irritation. This is often done with Sucralfate (Carafate).
Bilious vomiting syndrome can be treated with medication. Although it can be painful for your dog, cleaning up the vomit every day is not fun for you. These tips should help you get rid of this annoying, long-term condition.
Do you see your dog throwing up yellow? The Whole Dog Journal: What You Need to Know About “Bilious Vomiting Syndrome”
