Bilious Vomiting Syndrome in Dogs

Bilious Vomiting Syndrome in Dogs

Dog owners call them “hunger pukes.” The vet industry calls it “Bilious Vomiting Syndrome.”

You’d think anyone who uses an impressive term like that one to describe a condition in which a dog regularly pukes yellow liquid would know a bit about the problem. However, like so many other examples in veterinary and medical “science”, fancy names are invented for diseases which are complete mysteries and destined to forever remain so.

Should stomachs contain food 24/7?

Astoundingly, there seems to be consensus among vets that the real underlying cause of this condition is an empty stomach. They seem to forget that dogs have been walking around on this planet with empty stomachs 95% of the time during the millions of years they’ve been here. Even the relatively spoiled reintroduced wolves in Yellowstone only eat every third day on average. Other wild dogs not so well fed have been known to go weeks or even months without food, with no harmful effects.

My experience with bile vomiting

The problem of bile vomiting is very common and difficult to resolve for most dog owners. So much so that many have concluded that it is normal. Personally, I had almost given up trying to figure out why my middle-aged Cockapoo periodically vomited bile even after years of raw feeding. As is common, I had noticed that it always happened when his stomach was empty. It usually happened in the morning while I was in the kitchen preparing food. I asked everybody I could think of about this, including vets and expert raw feeders. I was always told that it’s just the sign of an empty stomach and I should feed my dog more frequently.

That was 25 years ago. I wish I could say that knowledge about this condition and how to resolve it has come a long way. Unfortunately, that’s not the case. No matter where you go for answers to this particular problem, you’re going to be told the same thing: Feed your dog more frequently. Or, feed a “bland diet.” Almost by accident, the latter might well resolve the problem temporarily, although it has little to do with “blandness”. As I will soon explain, these “bland” foods don’t contain the particular constituent in excessive quantities that causes the problem. They are not healthy foods, however, and will create disease if fed long term, a fact that even veterinary medicine agrees with.

In addition, when the dog owner goes back to feeding the dog’s regular food, the problem will eventually recur. I should note, also, that raw feeding alone does not solve this problem. Bile vomiting occurs in raw fed dogs as well as kibble fed.

More investigation and cogitation

When I was trying to unravel this mystery on behalf of my own dog, it didn’t make sense that the cause could be an empty stomach. As I’ve already pointed out, the stomachs of wild dogs are empty most of the time. One key difference seemed to be that when the bodies of wild dogs prepare to eat it’s because the prospect of food is real and imminent. Domestic dogs have no feeding autonomy. They are dependent on us for food, and it seems reasonable that their bodies can be triggered into preparing for it as a habituated response to certain environmental stimuli. This will happen whether or not food is actually forthcoming.

Getting closer to a solution

It seemed obvious to me that a combination of conditioning and my activity in the kitchen was causing my dog’s body to prepare itself for food. The act of hunting would do the same if he was living in the wild. However, dogs in the wild are not always successful when they chase food. In fact, they fail more often than they succeed. I’m loathe to think that they must then go off into the bushes and vomit unused bile every time. This seems too wasteful of valuable bodily resources to be true. Clearly there’s something going on in the diets of domestic dogs that either causes bile to end up where it shouldn’t be or that changes the bile itself.  What is it?

Digging deeper

To get to the bottom of the question requires taking a look at the function of bile. The job of bile in the digestive process is to break down fats. It seems logical to conclude that something is causing the body to overproduce bile. If that is the case, it also makes sense that over-consumption of fat may be the cause of the overproduction.

My own dog’s diet was 100% raw at the time he was regularly vomiting bile. But it was very high in fat, perhaps as much as 50% or more by calorie. After putting the theory together in my mind, I decided to immediately test it out. I did this by cutting way back on the fat content of my dog’s food. Previous to this, I had not been in the habit of trimming the fat from his food. I was even feeding a small percentage of cheap ground turkey, which often contains high fat.

I’ll tell you about the results of that experiment in a moment. First, I have to explain how overproduction of bile alone doesn’t entirely explain the problem of bile puking.  Overproduction does NOT account for 1) Why bile ends up in the stomach, where it apparently doesn’t belong, and 2) Why it irritates the stomach lining of domestic dogs but not of wild dogs. For the answers to those questions, we have to look at two known biological phenomena:

1. When the stomach is empty, a slight “backflow” of bile normally occurs through the intestinal tract, including the stomach.  Every 90-120 minutes during a fast, fluids naturally slosh back and forth between the upper intestine and the stomach. These usually-mild biological fluids act as a gentle detergent, cleaning out leftover undigested food and other debris in the digestive tract. (And incidentally, these ‘cleansing waves’ are responsible for those gurgling noises you hear from your dog occasionally. These are NOT normal because the more normal, watery fluids do not produce them.)
2. A diet inordinately high in fat causes the body to ALTER the chemical composition of bile.  When dogs are fed fatty diets, the liver alters its chemical recipe, causing the bile to thicken and concentrate. It transforms from a mild digestive aid into something that resembles a powerful chemical “degreaser” capable of stripping away protective tissue.

So, the natural backflow of bile into the stomach is normal and does not ordinarily cause harm. But the presence of a powerful degreaser cannot be tolerated, so the body invests the resources necessary to eject it. This is what accounts for the actual vomiting, because the protective stomach lining would itself be literally dissolved if the body did not eject the harmful fluid.

My experiment worked

Within a few months of sharply decreasing the amount of fat in his diet, my dog’s bile vomiting stopped. After that, it happened a few times a year for a couple years until it stopped completely. Since then, I have passed this information along to many others. When they make the same changes, they get the same successful results. Like with my dog, it can take weeks or months to completely stop but it typically steadily decreases until it stops permanently. I suspect the age of the dog is the primary factor that determines this.

The body does not make mistakes

Some dogs vomit bile in late puppyhood but have decreasing episodes as they grow into adulthood even if the diet does not change. Because of this, some people insist that bile vomiting is a normal part of physiological growth and development. We can be fairly certain this is not the case, however. It takes energy for the body to produce digestive fluids like bile. Living organisms are extremely economical. Everything has a function. The body doesn’t over- or under-produce by mistake, it does so in response to some deleterious influence. Our job is to find out WHY and remove the harmful influence.

In addition, there’s an important clue to be noted in the fact that the problem doesn’t usually show itself until a puppy is into the teenage months. What this tells us is that it is a condition that develops slowly over time. It’s just like many other forms of pathological degeneration. In other words, it takes a while for the body to accommodate itself to the high-fat diet. This most likely occurs earlier in kibble fed dogs than raw fed. Generally, the bigger the feeding mistakes the quicker the degeneration.

Do raw fed dogs vomit bile?

One would think that symptoms of all kinds would occur less in raw fed dogs. This is certainly the case generally. When it comes to bile vomiting, however, raw fed dogs are not spared. Bile vomiting is a very popular topic on raw feeding forums. Ironically, dogs on kibble may not actually exhibit the symptom as much as raw fed dogs. That’s because kibble stays in the stomach longer and bile vomiting almost always happens when the stomach is empty. Kibble is also typically fed more often, so the stomach is not empty as much. For this reason, bile vomiting may happen after a dog is transitioned to a raw diet even though the dog never experienced it before.  

Another fact that makes bile vomiting every bit as much a problem among raw feeders as kibble feeders is the fact that almost every raw feeder feeds commercial raw grinds.  These commercial grinds are EXCEEDINGLY high in fat.  Much higher than most kibble, in fact. 

Raw feeders are also more likely to embrace the idea that dogs need to be fasted regularly. While this is a very healthy habit, it also sets up the opportunity for the symptom to manifest.

Continued causes = continued effects

As a dog gets into adulthood, if the same feeding mistakes continue, the body continues to respond in the only way it can. It produces bile in the quantities and concentration it deems necessary to break down the excessive fats in the diet.

It is also sometimes noted that dogs begin to bile-vomit less as they get older. However, this does not necessarily mean they’ve “outgrown” the problem, as is sometimes surmised by feeding experts.

What it most likely means is that the stomach lining has become toughened by scar tissue as a consequence of frequent contact with the concentrated bile. Once the membranes are toughened, the cost of having the bile stay in the stomach may be less than the energy and resources required to eject it. Vomiting in general and bile vomiting specifically are costly to the body. If it can find a more efficient way to protect itself, it will. There will always be a cost, however. Like a callous on your hand or increased tolerance for alcohol in humans, a dog’s body will have to give up in sensitivity and vitality what it gains in protection. Increased tolerance always requires a decrease in vitality.

Obviously, a stomach that has had to adapt itself to wrong feeding will not be able to function optimally and efficiently. And since the body operates as a whole unit, there will be other problems caused by these mistakes. They may not show up until later in the dog’s life. But for our dogs’ sake, it would behoove us to take chronic bile vomiting as an early warning sign. It means that there is trouble ahead if we don’t make changes.

Is frequent feeding the answer to bile vomiting?

As I mentioned previously, frequent feeding is the best advice the veterinary profession has to offer. However, like most veterinary “fixes,” this is nothing but a secondary management strategy that is very costly to both dog and owner. One of those costs is that the dog will never be able to go a day without eating at all. This is almost universally recognized now (thank goodness) as a very beneficial practice. Digestion represents the greatest drain on energy of all the body’s various processes. This is particularly true for dogs that are overfed or mis-fed. Regular fasting greatly extends the life of dogs. It replicates what they adapted to in their long biological development as a species.

The only time a dog’s body can catch up on its eliminative backlog is when the stomach is empty. We can’t expect to have healthy dogs if we never give their bodies a chance to cleanse and heal, the way nature would. The body does lots of multi-tasking but it has its limits.

Excessive fats cause OTHER problems

Another cost to both dog and owner of not removing the cause of bile vomiting is that excessive fats cause a great deal of other HARM to the body.  When the liver is forced to continuously churn out high concentrations of bile acids, it triggers a state of chronic inflammation throughout the digestive tract. The inflammation is the body’s attempt to protect itself.  Over time, this constant tissue irritation and chemical stress can lead to systemic degeneration, leaving the body highly vulnerable to a wide range of serious chronic conditions, including cancer.

The very expensive “testing” rabbit hole

When the “frequent feeding” advice doesn’t work, vets will often recommend tests that purport to get to the bottom of the situation. Unfortunately, they don’t do that at all. When vets go looking for diagnoses, they’re not looking for causes that can be stopped. This would actually cost dog owners very little. And it would put all the power in the hands of dog owners. No, they’re looking for something to TREAT. This is often very EXPENSIVE for dog owners. Diagnosing is all about determining which drugs, homeopathic or herbal remedies to administer. It has nothing to do with discovery and removal of cause. For more information on the ineptitude of vets and vet-quoting websites on the issue of bile vomiting, please see my recent critique video.

Individual vets are not to blame

And for those who imagine I’m saying vets are laughing all the way to the bank, I’m not. I guarantee it never occurs to most vets that they’re not doing what’s best for dogs and dog owners. It’s what they are TAUGHT that is to blame. For that we have to look at who is “endowing” the educational institutions. “Endowments” from industry, in one form or another, greatly influence what vets are taught. In the current system, this effectively turns vets into drug and kibble sellers. The only ones who aren’t acting in that capacity are the “holistic” vets. And that’s only because they don’t sell drugs. But even “holistic” vets are not approaching bile vomiting or any health issue at its root cause. Instead, they are selling remedies and other products that only suppress symptoms, just like drugs.

Removal of cause is the most compassionate approach!

We would do well to consider the suffering of the afflicted dogs as well. Vomiting brings relief from the irritation caused by concentrated bile, but the act itself is downright unpleasant. For this reason alone, wouldn’t it be better to stay open to finding and removing the causes of this problem? So our dogs don’t have to experience it at all?

The big picture

The agricultural animals that we feed to our dogs have a great deal of fat on their bodies. That’s because they are overfed and fed unnatural, high-starch, drug-laced foods. By contrast, the natural diet of most prey animals produces a very low toxic load. And, importantly, much less body fat. These are the animals that our dogs are biologically adapted to eat. The foods that domestic dogs are fed, by contrast, diverge sufficiently from this to cause pathogenic conditions. These conditions are so common that they may seem inevitable, unavoidable, and even “normal”. Bile vomiting is a perfect example. Bile vomiting is common, maybe even so much so that it is “average”, but it is NOT normal. 

A dog does not need to be fed frequently or even fed organic/free-range/expensive foods in order to not suffer this problem.  All of the information a dog owner needs to prevent and REVERSE bile vomiting is just a click away.