home remedies for bilious vomiting syndrome in dogs

Bilious Vomiting Syndrome In Dogs Symptoms & Treatment

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What is Bilious Vomiting Syndrome In Dogs?

When your dog often throws up yellow/light or dark green liquid in early morning (or in the wee hours of the night ) but then gladly gulps the breakfast and gets on with her day, as if nothing had happened, then time has come to enlighten yourself with the term bilious vomiting syndrome (BVS).

This is an idiopathic, possibly a primary hypomotility disorder. Billious Vomiting Syndrome is due to bile build-up of excess bile irritating the empty lining of the stomach.

This may sound terrible, but as a matter of fact, the worst thing about the bilious vomiting syndrome is only the word syndrome.

When doctors and vets use the word syndrome, it usually means we have no idea what causes it. That indirectly says its an awful disorder. But not all, at least not BVS.

Billious Vomiting Syndrome - may have any number of causes, but fortunately, a number of solutions, too.

Symptoms Of Bilious Vomiting Syndrome In Dogs

• Vomiting (frothy yellow/greenish fluid)
• Nausea (eg., drooling, smacking lips)
• Pale gums, sunken eyes
• Signs of dehydration
• Temporarily reduced appetite

BVS does seem to be more reported in younger dogs (otherwise completely healthy dogs) than older ones.

Treatment Options For Bilious Vomiting Syndrome In Dogs

BVS is usually diagnosed based on:

Vets suggest two therapies for BVS:

Dietary - First, start with simple dietary changes. Late night dinner or feeding a bedtime snack or feeding denser food to decrease the time the stomach is empty during the night.

Medication:

A prokinetic agent: (e.g., cisapride, 0.1 mg/kg orally; metoclopramide, 0.2 to 0.4 mg/kg orally; erythromycin, 0.5 to 1 mg/kg orally).

H2 blockers: Pepcid, Zantac or Tagamet.

A gastric mucosal protectant: (e.g., antacid or H2-receptor antagonist, sucralfate).

Home Remedies For Bilious Vomiting Syndrome In Dogs

Step 1 - Provide a bedtime snack to increase gastric motility.

Step 2 - Stimulate the stomach into continuous motility by dividing the dog's daily food quota into multiple small meals.

If these steps do not work out means, go to step 3.

Step 3: Consult your vet and give an acid-reducer like Proton-pump inhibitors (omeprazole, esomeprazole, pantoprazole, etc) or H2RAs such as (ranitidine or famotidine).

Above three steps did not yield any results mean, go to step 4.

Step 4: Try a 'prokinetic' medication.

Metoclopramide (Reglan), cisapride, Macrolide antibiotics, Ranitidine, nizatidine, or lidocaine.

If those four steps don't work, go to Step 5.

Step 5: Check with your vet about gastroprotectant (protects gastric mucosa from bile irritation).

Sucralfate (Carafate) is the most prescribed mucosal protectant.

How to Prevent Bilious Vomiting Syndrome In Dogs?

The most common treatments that can prevent or reduce the BVS are:

1. Divide 3 meals into 5-6 mini-meals and introduction of a healthy late-night snacking right before sleep to decrease the night fasting period.
2. For meals later in-night, be careful with your food measurements and don't overindulge.
3. Some vets recommend feeding a little food in the morning (just like a trailer to breakfast).

Affected Dog Breeds Of Bilious Vomiting Syndrome

There is no breed disposition

Additional Facts For Bilious Vomiting Syndrome In Dogs

1. The most commonly cited theory: duodenal fluid refluxes into the stomach at nighttime (via the pyloric sphincter) and irritates the gastric wall. Decreased stomach motility causes the backwashing of fluid (containing bile) to cause the stomach mucosal lining irritation resulting in morning vomits. Vets sometimes call this 'reflux gastritis'.

2. We are familiar with acid reflux, in which acid-containing contents in the stomach backflows via the oesophageal sphincter (valve at the end) into the esophagus. This causes damage to the oesophageal mucosa and causes pain and heartburn. BVS is also the same process - sphincter level is one down.

3. Other causes of vomiting but this list is not meant to be all-inclusive:

• Addison's disease (adrenal insufficiency).
• Colitis.
• Cancer.
• Food allergy.
• GI foreign bodies.
• Gastritis.
• Giardia infection.
• Helicobacter infection.
• Hiatal hernia (stomach sneaks up into the diaphragm).
• Inflammatory bowel disease (IBD).
• Intestinal parasites.
• Liver failure.
• Physalopterosis (gastrointestinal infection caused by stomach worm).
• Pancreatitis.
• Stomach ulcer.

When To See A Vet For Bilious Vomiting Syndrome In Dogs?

• More vomits resulting in dehydration.
• Your pet has vomited several times.
• Abnormal vomit, either blood, pink, dark brown, or black.
• You are concerned about diarrhea or appetence or abdominal pain.
• Chronic BVS results in lethargy and loss of appetite.

Dog Food Suggestions For Bilious Vomiting Syndrome

What feeding times are best?

1. Fix a particular type of feeding schedule in place. This is one of the most important ways to lower the frequency of your dog's bilious vomiting.
2. Increased frequency of feedings may also help. Frequent small meals will make your dog's stomach full and can help stop acid from irritating the stomach lining.
3. Don't overfeed the dogs; make sure you still give your pet the same amount of food overall.
4. Provide normal dog food before they go to bed and feed them after you wake up in the morning.

Best foods for BVS:

1. 75% of a Dogs food should be complete, wholesome food certified by the Association of American Feed Control Officials (AAFCO).
2. The remaining 25% of your dog's diet can be canned food or other foods
3. A small bedtime low-fat snack
4. Bland diet: boiled chicken, cooked rice, tofu, low-fat cottage cheese, boiled hamburger, canned tuna, etc.,

Bilious vomiting syndrome (BVS) is a condition traditionally connected with vomiting of bile in the morning; however, it is otherwise inadequately characterized.

The good news: BVS is considered a benign condition. Recovery once treated for the specific cause has a good prognosis. Although it is self-limiting, follow the treatment plan prepared by your vet for your pet's specific situation.

Stomaching the Problem: Could Your Pet Have Bilious Vomiting Syndrome?

What is Bilious Vomiting Syndrome?

Bilious vomiting syndrome (BVS) is a term sometimes used to describe a condition where dogs vomit yellow fluid (called bile) or froth but not food after not eating for a long period of time (which for most dogs is typically early in the morning after not eating overnight). Other signs a dog with BVS may have include obvious nausea or reduced interest in food, especially first thing in the morning. Dogs sometimes show they are nauseous by smacking their lips, drooling, or just by showing less interest in food. For some dogs, it is thought that the fasting period between dinner and breakfast the following morning can result in some of the fluid from their intestines flowing backward into their stomach, which can lead to irritation, nausea, and vomiting.

Although BVS often has these typical signs and is typically not life-threatening, it is important to consult your veterinarian to rule out any other causes of vomiting in your pet, some of which can be serious, so they can recommend testing and treatment that is right for each individual dog. If standard diagnostics such as a blood panel and physical exam are suggestive of BVS rather than something more serious, your veterinarian may recommend dietary adjustments or medications.

How might my veterinarian recommend treating it?

There are many approaches to treating BVS, and it is important to consult with your veterinarian about which options might be best for your dog. One study reviewed dogs who were suspected to have BVS. Two of the most common treatments that stopped or reduced the vomiting were smaller, more frequent meals and adding an additional late-night meal right before bedtime to reduce the fasting period. Sometimes giving a small amount of food first thing in the morning, then waiting a little before giving a larger meal is also helpful. If your veterinarian diagnoses BVS in your dog and recommends a late-night meal, youll want to be careful with your food measurements! More frequent feedings should not mean additional food, but spreading out what she currently receives into more feedings. The total amount she gets per day should not go beyond your pets calorie needs that keep her at an ideal body condition.

Your veterinarian might also consider a change in diet or adding in medication, but each dog may have different needs. You should always consult your veterinarian before making any diet change to ensure it meets the nutritional and health goals for your dog.

References:

Leah Ferguson, Sara A. Wennogle, Craig B. Webb; Bilious Vomiting Syndrome in Dogs: Retrospective Study of 20 Cases (20022012).J Am Anim Hosp Assoc1 May 2016; 52 (3): 157161

This article was written in conjunction with veterinary student, Rachel Hanford.

Dr. Deborah Linder, a board-certified veterinary nutritionist, is the head of the Tufts Obesity Clinic for Animals and has had articles appear in Eating Well, the Boston Globe, AARP, SHAPE, and XM Sirius Radio Doctor Channel. She has spoken at national and international conferences and a Capitol Hillbriefing, and is an expert in pet obesity, nutrition communication, and in the human-animal bond.

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Feeding the Dog that Vomits Every Day

We spend a lot of time on Nutrition Nuggets talking about what (and what not) to feed our dogs. When dogs have bilious vomiting syndrome, however, when meals occur is even more important than what the meals consist of.

The classic symptom of bilious vomiting syndrome is vomiting on an empty stomach. This usually occurs first thing in the morning since most dogs dont eat throughout the night. Because the dogs stomach is empty, all that comes up is fluid, mucus, and often some bile, which tinges everything an orangey-brown color. Dogs with bilious vomiting syndrome are normal in all other respects no diarrhea, weight loss, poor appetite, etc.

We dont know exactly why some dogs develop bilious vomiting syndrome. The most commonly cited theory is that something is amiss with the normal housekeeping contractions of the gastrointestinal tract that should occur in between meals. As a result, fluid within the first part of the intestinal tract (the duodenum) moves backwards into the stomach resulting in irritation of the stomachs lining and vomiting. This explanation has resulted in some veterinarians calling the condition reflux gastritis.

Whatever the underlying cause, most dogs with bilious vomiting syndrome respond very well to a simple form of treatment feeding them their normal food right before bedtime and again first thing in the morning (yes, I mean even before you get a cup of coffee). I do not recommend changing the dogs food at the same time as the feeding schedule is being modified. As a veterinarian, I prefer to change one thing at a time whenever possible so I can better assess what is working and what is not.

If feeding the dog late in the evening and early in the morning doesnt improve matters, Ill generally recommend a health work up that consists of blood work, a urinalysis, a fecal examination, and abdominal X-rays to make sure that the dog is truly as healthy as he or she appears to be. In some cases, additional laboratory testing, an abdominal ultrasound, and/or scoping of the GI tract may be in order.

When a dog that is suspected of having bilious vomiting syndrome doesnt get better with more frequent feedings alone and other causes of chronic vomiting have been ruled out, medications can be added to the treatment plan. Some dogs respond to drugs that reduce gastric acidity (e.g., famotidine or omeprazole) while others do better with metoclopramide, a medication that increases the frequency of contractions within the small intestines, or maropitant, a broad spectrum anti-vomiting drug.

Even when dogs with bilious vomiting syndrome are treated with medications, they should continue to eat a late evening and early morning meal. If this is inconvenient, an automatic feeder is a worthwhile investment.

Dr. Jennifer Coates

Image: violetblue / Shutterstock

Bilious Vomiting Syndrome: A Complete Guide

Vomiting in dogs is not an uncommon thing, especially in puppies or more senior dogs. Usually, the vomiting is short-term and your dog returns to a normal healthy life. However, when the vomiting goes on for a long period of time or is seen with other signs, it may be a sign of an ongoing issue such as bilious vomiting syndrome.

What is Bilious Vomiting Syndrome (BVS)?

Bilious vomiting syndrome (BVS) in dogs is a condition where a dog vomits bile, typically in the morning or after a long fasting period. This is often accompanied by signs like hunger, nausea, and excessive salivation. It's believed to be caused by an imbalance in stomach acids.

If your dog experiences recurrent episodes, it's crucial to visit a vet for proper diagnosis and management.

What Are the Signs of Bilious Vomiting Syndrome?

The signs of bilious vomiting syndrome can be confused with other causes of vomiting, so aveterinary health checkis always recommended to work out the exact cause. Signs to look out for include:

• Vomiting yellow or green fluid
• Vomiting yellow foam
• Vomiting early in the morning or late at night
• Bright and otherwise well no other clinical signs such as diarrhea
• Vomiting stops after feeding

However, not all vomiting is related to bilious vomiting syndrome so signs linked with other causes of vomiting are:

How is Bilious Vomiting Syndrome Diagnosed?

Diagnosis is usually by ruling out other causes.Visit a veterinarianfor a health check-up for your dog. The veterinarian will ask lots of questions about the time of vomiting, duration, and consistency. If you have any photos of the vomit this can be helpful for the veterinarian to see.

The veterinarian may choose to run blood tests, X-rays, or ultrasound among other tests to work out the cause of your dogs yellow vomit.

Related reading: How Often Should I Take My Dog to the Vet?

How to Treat Bilious Vomiting Syndrome in Dogs

Bilious vomiting syndrome in dogs can be treated through a combination of dietary changes and medications. First, try feeding smaller, more frequent meals throughout the day instead of one or two large meals. You can also add probiotics to improve gut health and eliminate any food allergens or sensitivities from their diet.It's important to monitor your dog's calorie intake to prevent them from becoming overweight, which can worsen the condition and lead to other health issues such as osteoarthritis. Work with a veterinarian to develop a diet plan that meets your dog's nutritional needs and manages their symptoms.

Summary

Bilious vomiting syndrome is often a diagnosis of exclusion, that is all the other possible causes of vomiting have been ruled out first. The chances of managing this condition successfully are very good if diet and medical therapies are started and consistently followed.

However, this is a lifelong condition so its important to realize that accidents will happen from time to time and that is completely expected. If you are concerned that your pet may have bilious vomiting syndrome, schedule a visit your veterinarian.

Frequently Asked Questions

What types of dogs are predisposed to bilious vomiting syndrome?

There is currently not a lot of evidence as to the predispositions for this condition.One papersuggests male, middle-aged mixed breeds are more likely to get BVS.

Are there any natural anti-nausea medications for dogs?

Natural supplements to ease nausea from vomiting includeginger. Ginger alone may not be strong enough to stop vomiting from Bilious vomiting syndrome but talk to your veterinarian to see if this is a supplement worth adding to your dogs treatment program.

Should I be concerned about getting ill from handling my dogs vomit?

The risk for transmissible illness is low, especially if you are healthy and wash your hands thoroughly after cleaning up vomit. Transmissible illness includes bacterial infection, so older or immune-compromised people are at an increased risk, but with good hand hygiene, this risk should still be low.

My dog doesnt have bilious vomiting syndrome, what home remedies can I try?

For advice on home care for a sore tummy, read our blogfor some top tips on how to help your pooch.

I have more than one dog, how do I work out whos vomiting?

This can be a challenge! If you are waking up to vomit on a regular occurrence, you may need to separate your dogs into different rooms in the house or separate one dog each night for a few nights to see who the affected dog is. Its possible more than one dog may be affected. Another alternative is a home security system for you to watch the footage in the morning to find out whos affected.