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Bilious Vomiting Syndrome (BVS) in Dogs | BetterVet

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? 

Bile is produced constantly by the gall bladder to help in the digestion of fats. When there is no food in the gastrointestinal tract, the bile can travel backward up into the stomach. Here it causes irritation to the sensitive lining of the stomach. This irritation can trigger vomiting through chemical messages to the brain, or vomiting can occur due to the build-up of large volumes of bile in the stomach. 

Bilious vomiting syndrome causes vomiting usually either early in the morning or late at night when the stomach is empty. It differs from other causes of vomiting because the vomiting usually stops when you feed your dog, and your dog is usually otherwise bright and well. 

Bilious vomiting syndrome is similar to acid reflux in humans in terms of the sensation of irritation or burning to the stomach and oesophageal lining. In humans, the acid is from the stomach, and in dogs, it’s not acid but bile from further down the gastrointestinal tract that is causing this sensation. 


What are the signs of bilious vomiting syndrome? 

The signs of bilious vomiting syndrome can be confused with other causes of vomiting, so a veterinary health check is 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: 

  • Lethargy 
  • Reluctance to eat 
  • Weight loss 
  • Vomiting blood or vomiting what looks like coffee grounds 
  • Diarrhea 
  • Salivation or drooling 


How is bilious vomiting syndrome diagnosed? 

Diagnosis is usually by ruling out other causes. Visit a veterinarian for 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 dog’s yellow vomit.  


How is bilious vomiting syndrome treated? 

Bilious vomiting syndrome is treated with both medications and modifications in diet. For an in-depth review of treatment options read our blog here (link to what can I give my dog for throwing up bile). 

Medical treatment consists of intravenous fluid therapy to rehydrate your dog if they are dehydrated and medications to stop the vomiting in the short term. Longer-term medications are prescribed to help promote the removal of bile from the stomach and intestines by increasing the motility of the gastrointestinal tract. 

This is usually followed by changes in your dog’s diet to help them cope with their condition. 

The veterinarian will recommend altering the frequency of feeding times, usually to around four feeds a day if possible, with the first and last feed as early in the morning and as late at night as possible. This keeps the stomach partially full for longer during the day and gives the bile a job to do. 

Remember that the volume of food or the total amount of calories you feed your dog will stay the same, so the portion size will decrease with each feed. This prevents your dog from becoming overweight, which can lead to multiple other health issues such as osteoarthritis. 



What type of dogs are predisposed to bilious vomiting syndrome? 

There is currently not a lot of evidence as to the predispositions for this condition. One paper suggests 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 include ginger. 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 dog’s treatment program. 


Should I be concerned about getting ill from handling my dog’s 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 doesn’t have bilious vomiting syndrome, what home remedies can I try? 

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


I have more than one dog, how do I work out who’s 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 who’s affected. 



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 it’s 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, talk to a BetterVet today.