Bilious Vomiting Syndrome in Dogs

Published Feb. 9, 2012

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?