# Bilious Vomiting Syndrome



## brendagates (Jan 11, 2013)

My 6-year-old Havanese was recently diagnosed with bilious vomiting syndrome. When his stomach is empty, he vomits up bile. We have been working to fix this by adjusting his food schedule – we have been feeding him his daily portion of food spread throughout the day in 4 separate meals. It initially seemed to work, but then his vomiting just went back to the same frequency. He generally vomits up bile at least once every other day, if not daily. Usually in the middle of the night when his stomach is empty, but sometimes before dinner too. So frequency of meals hasn't helped. With his vet's advice, we put him on 5mg of Pepcid AC daily. That has helped somewhat, now he only vomits about twice per week. It's still not good enough and needs to stop completely. His vet just prescribed him a prescription food (we're waiting for it to be delivered, so haven't started on it yet), Hills Z/D. I am desperate for this to work, as I'm sure my pup is. 

Has anyone had experience with bilious vomiting syndrome that has any insight?


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## EvaE1izabeth (Nov 14, 2017)

I don’t know anything about the disease, but I know a little about the meds for human reflux because my son has severe reflux and a motility disorder. If it’s anything like treating humans, it may just take a little time to find the right meds. Pepcid is in a group of meds along with Zantac that is notorious for not working at all or working temporarily for some people. I think it can change the acid production of the stomach but it doesn’t always prevent throwing up. But it’s pretty traditionally the first med prescribed. DS threw up continuously on it but just didn’t cry about it when he was a toddler. He had better results from other meds, and a Nissen procedure. 

I hope you find the right thing and he feels better soon!


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## brendagates (Jan 11, 2013)

Thank you EvaE1izabeth. I appreciate your response. I will definitely ask his vet about an alternative medication to Pepcid/Zantac. Thanks for the suggestion!


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## Ollie"s Mom (May 23, 2014)

I know nothing, just wanted to wish you luck with the new food and to let us know how it goes.


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## JulieB (Jun 16, 2016)

Bodie doesn’t have the bilious vomiting but he would throw up a little bile early in the morning due to an empty stomach. I adjusted his meals and instead of feeding him twice a day I feed him at 7 am, 1 pm and 7pm then give him a little snack right before bed. It has done the trick. He’s on Hills ID digestive care food as he has a sensitive stomach. I hope you can find a solution, it took me a while to figure out what worked for Bodie. Good luck!


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## mudpuppymama (Mar 24, 2012)

If more frequent feedings are not helping, I would try increasing the quantity and feeding a snack before bed. I do not think suppressing a dog’s stomach acid production is a long term solution and could cause other problems down the road. To me, this is just suppressing the symptom and not getting to root cause which is typical of many vets. I would also question the quality of food and whether it is adequate to keep him satisfied long enough. I would also suggest talking to an animal naturopath or nutritionist so your dog can get off Hill’s which is not really a high quality food.


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## mudpuppymama (Mar 24, 2012)

JulieB said:


> Bodie doesn't have the bilious vomiting but he would throw up a little bile early in the morning due to an empty stomach. I adjusted his meals and instead of feeding him twice a day I feed him at 7 am, 1 pm and 7pm then give him a little snack right before bed. It has done the trick. He's on Hills ID digestive care food as he has a sensitive stomach. I hope you can find a solution, it took me a while to figure out what worked for Bodie. Good luck!


I just looked up the ingredients in Hills ID digestive care...the second main ingredient is corn. Does your vet really think this is good for your dog? I only mention this because long ago the vet had me put my cat on Hills food because he had some issues and it caused him all sorts of problems.


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## mudpuppymama (Mar 24, 2012)

brendagates said:


> His vet just prescribed him a prescription food (we're waiting for it to be delivered, so haven't started on it yet), Hills Z/D. I am desperate for this to work, as I'm sure my pup is.
> 
> Has anyone had experience with bilious vomiting syndrome that has any insight?


Please note that the main ingredient in this food is corn starch.


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## EvaE1izabeth (Nov 14, 2017)

mudpuppymama said:


> If more frequent feedings are not helping, I would try increasing the quantity and feeding a snack before bed. I do not think suppressing a dog's stomach acid production is a long term solution and could cause other problems down the road. To me, this is just suppressing the symptom and not getting to root cause which is typical of many vets. I would also question the quality of food and whether it is adequate to keep him satisfied long enough. I would also suggest talking to an animal naturopath or nutritionist so your dog can get off Hill's which is not really a high quality food.


If the diagnosis is bilious vomiting syndrome, isn't that the root of the problem? It's important to consider that the problems down the road from suppressing acid production may far outweigh things like poor growth, gastrointestinal side effects from throwing up on a daily basis, etc.

I don't think it ever hurts to seek out a second opinion. I would be very careful about any diet changes without the help of a nutritionist in this situation, especially in the middle of the vet's diagnostic and treatment process.


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## EvaE1izabeth (Nov 14, 2017)

You might also ask the vet to clarify what reasonable treatment goals look like if you haven’t already. I don’t know about this disease, but it may be that occasional vomiting is inevitable and the goal is to minimize it and make sure the dog isn’t traumatized and it isn’t overwhelming to you. Not to keep compare two very different situations and anatomies  but we learned to keep an extra shirt and wet wipes in the trunk of our car, not to give our son certain foods without a drink, etc. Even with medication he vomited from whatever is below his stomach (duodenum?) when he was sick. It wasn’t painful for him, just inconvenient. We learned these things over time and as we adapted it became easy to manage. If treatment is expected to completely resolve the problem, that’s great news, and it means you know when he needs to see the vet.


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## mudpuppymama (Mar 24, 2012)

EvaE1izabeth said:


> If the diagnosis is bilious vomiting syndrome, isn't that the root of the problem? It's important to consider that the problems down the road from suppressing acid production may far outweigh things like poor growth, gastrointestinal side effects from throwing up on a daily basis, etc.
> 
> I don't think it ever hurts to seek out a second opinion. I would be very careful about any diet changes without the help of a nutritionist in this situation, especially in the middle of the vet's diagnostic and treatment process.


It is normal for a dog to vomit bile when it is hungry. Bilious vomiting syndrome is some fancy medical term for a dog being hungry and needing food. This is a symptom. The solution is to figure out why your dog is hungry. Typically more frequent feeding helps but I have seen cases where the food quantity must be increased also. I suspect this could also be caused by food of lower quality (eg too starchy) that does not sustain the dog from meal to meal. Digestive issues are indications to humans that something needs to be addressed with the dog's diet. Suppressing the symptoms is not the answer. I agree...get a second opinion. And please read the ingredients label on the Hills prescription diet food. This is overpriced low quality food that vets sell. Sorry, I just have to be honest. Someone has to be an advocate for our pets. The vets typically are not.


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## Jackie from Concrete WA (Mar 23, 2015)

Willow will vomit up bile every once in awhile. It's usually in the morning after she gets up. I didn't realize hunger could cause it. She doesn't do it very often - maybe once every other month or so. She never seems to feel sick when she does it and goes right back to her crazy self. She'll play and eat normally. Doesn't act sick at all.

I sure hope you can get to the root of the vomiting problem with your. dog He is beautiful and as cute as can be. I'm so sorry you are having to deal with this.


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## krandall (Jun 11, 2009)

EvaE1izabeth said:


> If the diagnosis is bilious vomiting syndrome, isn't that the root of the problem? It's important to consider that the problems down the road from suppressing acid production may far outweigh things like poor growth, gastrointestinal side effects from throwing up on a daily basis, etc.
> 
> I don't think it ever hurts to seek out a second opinion. I would be very careful about any diet changes without the help of a nutritionist in this situation, especially in the middle of the vet's diagnostic and treatment process.


I agree completely. It's one thing to suggest that someone might want to consider a second veterinary opinion. It's another thing entirely for complete lay people on an Internet forum to start second-guessing a vet's treatment protocol for an ill dog.


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## brendagates (Jan 11, 2013)

Thank you all for your thoughtful responses, advice and concern. I so appreciate it!

Malfoy has been on Natural Balance Limited Ingredient Diet Fish and Sweet Potato since he was a puppy – we first tried Blue Buffalo and Wellness and they gave him diarrhea and skin allergies. He also always has been a bile vomiter (once every month or so) his entire life. About 8 months ago, the bile vomiting increased frequency until he was vomiting bile every single day. At that time I increased his feedings to 3 times per day. It didn’t help. Then I switched his food to Rachel Ray Just 6 Lamb and Rice. This helped slightly, but not enough. He was vomiting every other day or so. He behaves normally, but I am worried about the long term damage to his stomach and esophagus from the daily bile vomiting. 

I increased his feedings to 4 times a day on most days. His vet suggested 5mg Pepcid daily and that barely helped, so now we’re on day 5 of his new prescribed food, Hills Z/D (mixed with some of his old food for the transition). No vomiting yet. It’s promising and I am hopeful. But I am definitely concerned about him eating a low quality corn-starch based food for the long term. I will have to switch him again to something else and cross my fingers.

Any high quality food suggestions?

Thanks everyone. You’re the best!
Brenda


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## EvaE1izabeth (Nov 14, 2017)

I’m so glad he’s doing better! 

I think a nutritionist would be the best person to help with this because that person can help you figure out your goals, food budget, etc. and better analyze what is in the food that is helping. I don’t think it undermines the vet’s treatment to work with a professional now that it’s improving and other medical issues are ruled out. I looked into the cost of a consultation with a pet nutritionist and it seemed reasonable, especially compared to the cost of rotating through a bunch of foods on my own. The nutritionist often recommended here on the forum has several different options at different price points, so hopefully someone can give that referral. You might be able to find it in old threads by searching “nutritionist.” If he’s developed an allergy or food sensitivity over time, it might be really helpful long term.


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## mudpuppymama (Mar 24, 2012)

EvaE1izabeth said:


> I'm so glad he's doing better!
> 
> I think a nutritionist would be the best person to help with this because that person can help you figure out your goals, food budget, etc. and better analyze what is in the food that is helping. I don't think it undermines the vet's treatment to work with a professional now that it's improving and other medical issues are ruled out. I looked into the cost of a consultation with a pet nutritionist and it seemed reasonable, especially compared to the cost of rotating through a bunch of foods on my own. The nutritionist often recommended here on the forum has several different options at different price points, so hopefully someone can give that referral. You might be able to find it in old threads by searching "nutritionist." If he's developed an allergy or food sensitivity over time, it might be really helpful long term.


I think this is awesome advice. With regard to budget, I just wanted to add that I have been feeding two dogs a homemade diet for nine years and in my experience it is actually cheaper than commercial food, plus you have the peace of mind knowing what is in your dog's food and that to me is priceless.

With regard to corn and soy, in addition to be problematic for dogs, these are both GMO crops that are heavily sprayed with Roundup. So if a dog is eating corn and soy, he is eating food laden with pesticides. Just another reason to get dogs off of it in my opinion.


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## davetgabby (Dec 29, 2007)

EvaE1izabeth said:


> I'm so glad he's doing better!
> 
> I think a nutritionist would be the best person to help with this because that person can help you figure out your goals, food budget, etc. and better analyze what is in the food that is helping. I don't think it undermines the vet's treatment to work with a professional now that it's improving and other medical issues are ruled out. I looked into the cost of a consultation with a pet nutritionist and it seemed reasonable, especially compared to the cost of rotating through a bunch of foods on my own. The nutritionist often recommended here on the forum has several different options at different price points, so hopefully someone can give that referral. You might be able to find it in old threads by searching "nutritionist." If he's developed an allergy or food sensitivity over time, it might be really helpful long term.


yes , Sabine would be very helpful, [email protected]


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