Bilious Vomiting Syndrome

Dog Food Advisor Forums Diet and Health Bilious Vomiting Syndrome

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  • #126379 Report Abuse
    Bernice L

    I have a 5 year old Frenchton who has had stomach issues off and on since a puppy. As a result he has always been on Royal Canin Gastro Low-Fat which seemed to keep his symptoms to a once or twice a year event. Until this year. This year Freddy has been constantly in and out of hospital with severe vomiting, nausea, pain and weight-loss. He was diagnosed with pancreatitis, last level testing was 274, but my vet really felt there was more going on since nearly all of his episodes lately occur in the middle of the night. Freddy was referred to Dr. Hans Gelens, a veterinary internal medicine specialist who has been a life-saver for me. He diagnosed Freddy with bilious vomiting syndrome (on top of the pancreatitis) which is apparently not uncommon in dogs. At this time Freddy is being treated with a new food regimen, although still on the RC LFG (apparently the best option from all of the vets I have consulted with), he now receives smaller meals spread out throughout the day with a last “snack” literally right before bedtime, along with a dose of Omeprazole at that same time (it is a prescription ant-acid, but I do fill it through my regular pharmacy to save costs). Freddy is to have no fat-laced snacks or treats so receives basically dried fruit/veggie snacks (pancreatitis can be triggered by fat in the diet), of course no “human” leftovers and quiet time for at least one hour post-meal. Finally, it has been 10 days since Freddy’s last vomiting episode and the nausea seems to be settling down (lip-smacking, drooling, yawning, licking are classic signs of nausea in dogs). After a year totaling over $5000 in vet bills I hope this recovery will continue.

    I am sharing this because prior to seeing the specialist I had never heard of bilious vomiting syndrome, but I have seen some posts on here where owners describe dogs with similar symptoms to Freddy’s so I thought it was important to share this information.

    Good luck to all dog lovers out there whose pets have health issues.


    #128280 Report Abuse
    Dawn H

    I have a 9yo dachshund mix (15lb) who had pancreatitis 2 yrs ago for the first time. He now eats wellness core grain free low fat kibble. I wanted a food that didn’t require a prescription and cost a fortune. If that didn’t work I would have gone the prescription food route. He gets charlee bear liver treats and old mother Hubbard mini puppy biscuits (I get the puppy ones because they are smaller). Both are low in fat. He gets no other treats/biscuits. No people food except green beans, rice, raw spinach and the occasional baby carrot. He also gets half of a multivitamin with digestive enzymes at each meal.
    He will vomit, usually in the am if he eats too late. I use the charlee bears and old mother Hubbard treats as snacks. Vomiting on an empty stomach is common in small dogs. When I worked at the vet, they always said it was partially from drastic changes in blood sugar. So multiple small meals are best.
    They also said not to be on omeprazole (prilosec) or famotidine (pepcid) long term, though I don’t remember why. I will see if I can find out their reasoning. Hope freddy is doing well!

    #128282 Report Abuse
    Patricia A

    My neighbors dog was diagnosed with this as well. Make sure he does not go to bed on an empty stomach and feed first thing in morning. This is what really helped her dog and without medication. Here’s an article that is helpful also.
    The classic symptom of bilious vomiting syndrome is vomiting on an empty stomach. This usually occurs first thing in the morning since most dogs don’t eat throughout the night. Because the dog’s 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 don’t 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 stomach’s 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 dog’s 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 doesn’t improve matters, I’ll 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 doesn’t 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.

    #128285 Report Abuse

    I agree, somewhat, I give my dogs a bite of chicken (not a meal) when they come in from their bedtime bathroom break, it’s a reward, they expect it now.

    I think the trick may be not to go more than 4 hours without having something in their tummy.

    Also, if they are not water drinkers, add at least a splash or more to their 2 main meals per day.
    I would not free feed, leave food out all day or use an automatic feeder. They will binge and get sick.

    #128290 Report Abuse

    PS: If you feed a meal at say 10p then expect to let the dog out between 2a-3a for a bathroom break (bowel movement)
    Been there, done that 🙂

    #128303 Report Abuse

    Hi Bernice.

    “Bilious Vomiting Syndrome in Dogs, aka “Hunger Pukes”

    How did your Dr. Hans Gelens diagnose Freddy with bilious vomiting syndrome?
    Did Freedy have Biopsies thru a Endoscope?

    You wrote
    “lip-smacking, drooling, yawning, licking are classic signs of nausea in dogs”

    Lip Smacking, licking paws, blankets, floors, grinding teeth, yarning-(stress), swollowing gulping are classic signs of “acid reflux”, my vet said she see’s at least 1-2 dogs a week who are suffering with acid reflux, it’s more common then we think with dogs,
    this is why Freddy has been put on Omeprazole (Prilosec) an acid blocker, it’s a PPI (Proton Pump Inhibitor)… Why didn’t the vet put him on a lower class of acid reducer drugs histamine-2 (H2) blockers either Zantac (Rantidine) or Pepcid (Famotidine) instead of a PPI??

    A diet change would be good idea once Freddy is doing well again & is stable.
    He was eating Royal Canin Gastro Low-Fat which seemed to keep his symptoms to a once or twice a year event. “Until this year”. Diet may have contributed to his Bilious Vomiting Syndrome??
    Look at eating fresh whole foods, a lean balanced diet, not over processed dry kibble/wet can dog food. Look at feeding diet that’s low in carbs, low fiber especially with Pancreatitis NO sugar in diet, stay away from foods that bring on acid reflux..

    You can NOT just stop taken a PPI once you have been taken it more then 14-20 days, a PPI must be slowly reduced & a lower class of drugs called histamine-2 (H2) blockers either Zantac (Rantidine) or Pepcid (Famotidine) are given for 2-3 weeks after the PPI has been stopped but first reduced & give PPI every 2nd day then when you’ve stopped then you give either Zantac or Pepcid 30mins before a meal…
    Zantac & Pepcid work differently they dont work like a PPI works (Omeprazole or Pantoprazole)… A PPI is better but you have to work out do you want Freddy on a PPI now for the rest of his life??. if you have tried Zantac & Pepcid & they didn’t work then yes give PPI & diet change, vet diets are very high in Omega oils which is a good thing BUT some dogs who have Pancreactitis, IBD can’t handle high fish Oil, Coconut Oil etc & can get acid reflux my boy is one of those dogs, when eats a vet diet he get his bad acid reflux & yeasty itchy skin due to food sensitivities, I didnt know Fish/Salmon Oils & Coconut Oils could cause acid reflux until I seen Dr Judy Morgan talking about her 18yr old Cavalier charles, he has Pancreatitis & every month he kept having a Pancreas flare so she stoped adding all his supplements & slowly added them back weekly 1 at a time & it was the fish oil causing his monthly pancreas flare….
    Follow Dr Judy Morgan DVM on her f/b page also look at her “Videos” she has a really good “Pancreatitis Diet” you make in a Crock pot & add The Honest Kitchen Base

    My Patch has been on Omeprazole 2 yrs then he went down hill again this time last year he’s 10yrs old, he had another Endoscope & Biospy done in January 2018 to see why he’s got really his bad acid reflux again & he was already taken a PPI so he shouldnt be getting really bad acid reflux but he was, I did diet change but he didnt get better, so we did Endoscope + Biopsies the vet said as he was looking thru camera his wind pipe was inflammed & red, so was his Esophagus, he has lower esophageal sphincter (LES) his flap doesnt close properly & his acid wash back up his esophagus into throat mouth then went down into his wind pipe, por thing this would be very painful… He also suffers with Helicobacter living in his stomach walls, staying on a PPI like Omeprazole or Pantopazole is suppose to help stop the Helicobacter living & thriving in the stomach wall, I wonder if this is what Freedy has?? if after 6months -12months & Freedy goes down hill again try a diet change a lean cooked diet & ask vet can he please do an Endoscope + Biopsies, the Biopsies are a must as they will give vet some answers & the only way to know if the Helicobacter has taken over his stomach, all dogs have Helicobacter but when their immune system is compromised the Helicobacter takes too much bad bacteria, making you feel very unwell, stomach pain, nausea, bad acid reflux & feeling hungry all the time & weight loss..
    I asked Patches vet can I PLEASE change his PPI from 20mg Omeprazole to 20mg Pantoprazole, I also take Pantoprazole it seems to work better for people who have GERDS & suffer with bad reflux…
    PPI are best given of a morning not night unless he’s taking a PPI twice a day, I wouldnt recommend taking a PPI twice a day for a dog, best to start off on a lower dose, 1 x 20mg tablet take of a morning as soon as he gets up I give Patch his 20mg Pantoprazole tablet & I have a 20ml syringe water so I know the tablet has gone down his throat, you can NOT chew PPI tablets, they are specially coated tablets so they digest past the stomach so dont let Freddy chew his Omeprazole if you can this is why best not to give with food as they chew food, just open his mouth & put tablet on back of his tongue & put down throat, then put the syringe side of his mouth back teeth & slowley squirt water so he swollows tablet & make sure he doesnt spit tablet back out, my Patch was sptting back out after I walked away & I was finding his tablet, cheecky bugger…

    My boy has IBD he eats 5 smaller meals a day he eats –
    First meal after he has taken his PPI around 6.30-7am then another small meal around 9am, Lunch- 12pm a cooked meal or freezed dried raw dehydrated meal about 1/3 a cup, 5pm-Dinner meal is bigger under 1 cup & 7.30pm small 1/4 a cup & last meal for the night wee & then he goes to bed & I wake him for 2 wee breaks & he gets a Quick-Eze 1/2 a Rapid Chew after his last wee around 10.30-11pm & I always offer him water when Patch wakes up on my bed, he is very weird about drinking water when he has his acid reflux, so Im always offering him fresh water to wash down any acid…
    I’ve been freezing Bone Broth in ice cube trays & take out 1-2 ice cubes to thaw & Patch drinks it & loves the Bone Broth, I think The Honest kitchen has a Bone Broth you can buy, there’d be a few places taht have teh Bone Broth.

    I hope Freedy recovery continues, but if he has a set back then look into diet change, there’s healthier alternatives for these sick dogs & cats, after seeing sooo many dogs get better on a healthier diet, I really think once dog is stable & has been doing really well start looking into changing dogs diet, fresh lean meats, fresh veggies & fruits, Kefir given or a probiotic best to give on empty stomach or inbetween meals when Hydrochloric acids in stomach are low, make sure diet is balanced properly, there’s a few good foods that are dehydrated & aren’t over processed & over cooked till all ingredients are all brown or black.

    #166258 Report Abuse
    Barbara D

    Hi There, I just read your post. I am thinking of taking my dog to see Dr Hans Gelens and I am wondering if you are still getting good results with your Freddy after seeing Dr Gelens. Thanks so much!

    • This reply was modified 2 years, 11 months ago by Barbara D.
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