Vomiting with Bile in Cats

PetMD Editorial

Published Sep. 29, 2009

Bilious Vomiting Syndrome in Cats

Bile is a bitter, yellow-green fluid that is created in the liver and stored in the gallbladder until food has been ingested. It is then released into the small intestine to aid in digestion of food and to emulsify the food so that it can be used appropriately by the body. Bile also carries various waste materials out of the body along with the feces.

Bilious vomiting syndrome occurs due to motility problems, when bile abnormally enters into the stomach, causing irritation and vomiting. That is, when the gastrointestinal tract fails to react automatically to the normal functions that occur within the tract, contents in the tract do not move as they should, causing abnormal behaviors within the system. Bile that has entered into the stomach is expelled by the cat, and the vomit contents are found to contain bile.

This reaction is usually seen in the early morning or late night just before eating, especially in cats that are fed once daily. It is a rare condition in cats; when it does occur it is usually in older cats. Both genders are equally affected.

Symptoms and Types

Chronic intermittent vomiting containing bile
Usually occurs in the morning or late night just before eating
Abdominal discomfort
Nausea
Lack of appetite
Weight loss

Causes

The exact cause is still unknown
Diseases causing gastritis or inflammation of the intestine, leading to modified gastrointestinal motility

Diagnosis

You will need to give a thorough history of your cat's health, a background history of symptoms, possible incidents that might have led to this condition, and recent activities. As much as you can, you will need to tell your veterinarian when the symptoms began, and how frequently the vomiting occurs.

Your veterinarian will then perform a thorough physical exam on your cat, with a complete blood profile, a chemical blood profile, a complete blood count, and a urinalysis.

A history of intermittent vomiting with bile contents is usually enough for a preliminary diagnosis. In the course of diagnosing this disease, laboratory testing is not of much help as the results are usually within normal ranges. Specific radiographic and ultrasound imaging studies of the abdomen may reveal delayed stomach motility. Endoscopic examination often returns normal in these patients.

Treatment

If there is no serious underlying disease present, your doctor will decide on an appropriate line of treatment based on the symptoms. Drugs to enhance gastric motility will be used to overcome delayed emptying of stomach, increase stomach and gut motility and thus prevent reflux. Also, drugs that will decrease acid secretion in the stomach can be used to prevent damage to the stomach wall due to the increased acidic contents of the bile.

Most patients respond well to such treatment; the length of time your cat is going to need medication will depend on its individual response. Some animals respond quickly to the treatment, while others need a longer course of medication. For patients suffering chronic bilious vomiting, dietary management is a very important component of treatment, usually involving feeding small, frequent meals, especially late at night. Preventing the stomach from being empty for long periods of time will help to increase normal stomach motility. Diets low in fat and fiber content will also help the stomach to empty and reduce gastric retention of food.

Your veterinarian may also suggest canned or liquefied diets, which also can be helpful in such patients because solid food tend to stay longer in the stomach.