Bilious Vomiting Syndrome


Our experience with bilious vomiting syndrome in dogs and cats can help guide you to a better understanding of how to more naturally support canines and felines with this condition. It can be very upsetting for a pet parent to have a dog or cat that is nauseous and vomiting. A pet with bilious vomiting produces a yellowish vomit that doesn’t seem to be associated with anything in particular, such as a meal or ingestion of some unknown substance.

The following informational material is provided by a certified Master Herbalist and Canine Nutritionist with The Pet Health and Nutrition Center to provide you with a better understanding of bilious vomiting syndrome in dogs and cats that will help you to approach this condition without those feelings of panic or hopelessness to help reduce stress for your dog and yourself.

1. What is Bilious Vomiting Syndrome in Dogs?

Dog bilious vomiting is usually associated with early morning vomiting of empty stomach contents and bile. The vomit is typically a Green or yellow color that can be upsetting to the dog's owners. This coloration is attributed to the color of empty stomach fluids, but also bile that is a result of reflux of duodenal fluid back up into the stomach.(1) When the body is behaving normally this bile continues down into the more distal parts of the digestive tract and most is eliminated in stool.

2. What are the Causes of Bilious Vomiting Syndrome in Dogs?

The answer to this question can vary with who you ask and whether their view point in more allopathic or holistic. Our research and experience gives us a very good idea why dog bilious vomiting occurs and the most common causes include a dog that consumes too few calories, has malabsorption issues or experiences gastritis.

  • Too few calories

    By feeding too little food a dog's stomach will become empty for an extended period of time. When your body expects food your stomach releases ghrelin, a hormone that makes you feel hungry, and with an empty stomach this can produce feelings of nausea.

    In addition, when hungry, the hydrochloric acid in the empty stomach can slosh around preparing for food that doesn't come causing nausea. This churning in the stomach can also cause the lower esophageal sphincter to relax at the wrong time allowing stomach contents to move backward into the esophagus referred to as acid reflux.

    If you are wondering how bile enters the stomach from the duodenum, this occurs because the vomit reflex, part of the parasympathetic nervous system, causes the pyloric sphincter at the base of the stomach to relax. This allows the liquid contents from the upper intestine to move backward into the stomach and become part of your dog's bilious vomit.

  • Malabsorption

    When a dog has malabsorption issues(2) they will experience physical effects similar to ingesting too few calories. By this I mean that their stomach and brain will interpret the poor assimilation of nutrients as hunger. This typically expresses as early morning dog bilious vomiting that many pet owners experience.

  • Gastritis

    This is a condition in which there is inflammation of the lining of the stomach that can contribute to bilious vomiting syndrome in dogs. The reason vomiting occurs is related to the two causes described above. An inflamed gastric mucosa will not provide digestive gastric secretions efficiently resulting in poor assimilation of nutrients and feelings of hunger, nausea and related discomfort. This, for the reasons described above, can result in dog bilious vomiting.

3. What are the Symptoms of Bilious Vomiting Syndrome in Dogs?

Our research and experience indicate that the most common symptoms a dog with bilious vomiting syndrome will display, either before or during a bout of bilious vomiting, include vomiting empty stomach contents and bile, nausea and less interest in their food.

  • Vomiting

    A dog with bilious vomiting syndrome will vomit after not eating for a period of time. The time that vomiting occurs can vary with the dog and seriousness of the condition. However, usual times are in the early morning after not eating overnight and some dogs will not even make it to the morning and vomit overnight.

    Since a dog with bilious vomiting syndrome will vomit on an empty stomach, the color will be greenish-yellowish due to the primary contents being fluid from the empty stomach mixed with bile.

  • Nausea

    Dogs that are nauseous generally smack their lips, drool, shake, pant, whine or will arch their backs described as abdomen tucking. However, one of the more common signs of nausea is a dog that will urgently eat grass or green houseplants. This is believed to be an instinctive behavior in an attempt to induce vomiting.

  • Show less interest in food

    This will be related to nausea or gastritis and a dog that is not feeling well and uncomfortable will be less interested in their meal.

4. Bilious Vomiting Syndrome in Dogs Diet

Dogs that experience bilious vomiting often have one thing in common: they are not receiving the necessary nutrition and satiety from the food they eat due to poor digestion and absorption of nutrients. It is important for a dog with bilious vomiting to be fed the proper amount of a raw or cooked whole food diet. This is because processed pet food diets are typically high in carbohydrates and digest quickly leading to an empty stomach and low blood sugar. Both of which are prime contributors to dog bilious vomiting.

5. Home Remedies for Bilious Vomiting Syndrome in Dogs

When we think of home remedies for a dog with bilious vomiting we should consider herbs or foods that reduce nausea and gastric upset. Right away ginger root, fennel seed, licorice root, slippery elm bark, marshmallow root come to mind to soothe the stomach and reduce nausea. These herbs can be provided in tea form or dry powders mixed into a little treat food. Home remedies to try for dog bilious vomiting include:

  • Herbs that help with nausea, like ginger tea or powder, mixed into some treat food like pumpkin or chicken broth. These can be given prior to meals or when you notice that your dog is nauseous prior to vomiting.
  • Feeding a small meal to help settle your dog's stomach prior to a larger meal
  • Providing a treat at night before bed that will provide some fat for satiety like organic almond butter in a Kong toy or on a cookie.

6. How do Veterinarians Treat Bilious Vomiting Syndrome in Dogs?

Veterinarians use pharmaceutical drugs to address symptoms. These symptoms are lumped under a 'disease" diagnosis. This is called allopathic medicine. For a dog with bilious vomiting the drugs of choice are antiemetics (medications that treat nausea and vomiting), antacids to reduce stomach acid and irritation (chronic use is a big mistake in our experience), steroids to reduce inflammation, and antibiotics as insurance against the "possibility" of a bacteria being the cause of the vomiting. While medications can be helpful in certain cases, they primarily address symptoms, and not the underlying issue, while having the potential for numerous side effects.

5. Bilious Vomiting Syndrome in Dogs Holistic Protocol

Our Dog Bilious Vomiting Protocol has been assembled by two experts in natural pet health care with two decades of experience in this field. We address this health issue in a holistic manner. Meaning we seek to address the underlying reasons for your dog's vomiting to achieve real healing. In our holistic protocol for a dog with bilious vomiting, the primary areas we address include:

  • Ensuring your dog is fed the correct diet and proper amount of food
  • Providing supplementation to ensure your dog digests his food properly
  • Providing supplementation to support digestive organs such as the pancreas, liver and gallbladder
  • Providing herbal remedies to address inflammation and irritation in the lining of the digestive tract and promote healing of damaged tissue

Core Recommendations Suggested remedies are included in the Core Dog Bilious Vomiting Package found below.

Our "Core Recommendations" form the backbone of our Holistic Bilious Vomiting Syndrome in Dogs Protocol. They consist of the supplement recommendations we feel are the most important to provide to your animal companion. Supplements are displayed individually or as a package at the bottom of this page along with other helpful remedies from which you may make additional selections.

A complimentary Dog Bilious Vomiting Help Sheet is included with every core supplement package purchase. If you require more direction to discuss your dog's treatment options please feel free to use our Email Consultation Form.

Vitamin Supplement for Dog Bilious Vomiting

  Core Recommendation #1 - Daily Multi Plus

Our Daily Multi Plus is formulated with organic, whole foods that are extremely important to an animal's nutritional needs but are often missing from the majority of canine and feline diets. This special formula provides the digestive enzymes, probiotics and whole food prebiotics that are so important for the proper digestion of a dog with bilious vomiting. This daily multivitamin formula also provides New Zealand glandulars and a WIDE variety of vitamins, minerals, antioxidants and phytonutrients in a organic, whole food form that are so beneficial to increase the nutritional profile of a dog's diet!

Stomach Soother for Bilious Vomiting Syndrome in Dogs

 Core Recommendation #2 - Stomach Soother

Our Stomach Soother is the ideal herbal remedy to help a dog with bilious vomiting feel better quickly. Formulated with USDA organic herbs, this remedy will help to alleviate nausea and irritation in a dog's stomach that leads to bilious vomiting. Made with USP organic vegetable glycerin so it tastes great and is easy to squirt directly in mouth or into food. In our experience this herbal remedy is a good alternative to antacids that can interfere with proper digestion and make matters worse over time.

Colostrum for Dog Bilious Vomiting

 Core Recommendation #3 - Repair and Strengthen

This supplement provides organic aloe vera and colostrum to help reduce inflammation and heal tissue in the digestive tract. In addition, Repair & Strengthen also provides glutamine which is a natural amino acid found in whey protein and well known as a nutrient important to cellular repair in the digestive tract.

Other Recommendations

Best Dog & Cat Food for Irritable Bowel Disease Whole Food Nutrition

According to Maria Reich, our canine nutritionist, a dog with bilious vomiting syndrome typically has one of two issues we have to consider. First, is that they are not getting a proper diet that is fulfilling their nutritional needs. Second, is that they are not digesting their food properly and because of that they are not getting the nutrition from their diet that they should.

Because processed pet foods diets are almost always high in carbohydrates, these types of diets are an issue for a dog with bilious vomiting syndrome. This is because they will digest these foods quickly, and this will lead to an empty stomach and low blood sugar. Both of these outcomes can lead to nausea and trigger the brain-vomit reflex.

For this reason we highly recommend a whole food diet, either raw or cooked, for dog bilious vomiting. This diet can be a commercial prepared diet, a dehydrated diet to which you add your own meat or you  may decide to make your dog a homemade diet. For more information and some product recommendations read our article How to Feed Your Dog or How to Feed Your Cat that can be found in our Education section.

Herbal Digestive Tonic as Bilious Vomiting Syndrome in Dogs Treatment

 Herbal Digestive Tonic

This is a wonderful, natural digestive tonic that will help your dog to better digest his food. Because poor digestion can contribute to dog bilious vomiting, this digestive tonic can be very beneficial for helping your dog feel better and get healthier. Since this does contain apple cider vinegar and is formulated to acidify the gut to aid digestion in the stomach, we feel this should be added in when your dog is over the acute vomiting phase so it does not potentially bother an irritated stomach.

Nat Phos #10 Cell Salt for Dog Bilious Vomiting

 Cell Salts

Cell salts are minerals naturally found in cells within the body. When there are deficiencies within cells imbalances can result. They are very safe and easy to give. Stomach Soother recommended above is very good at balancing over-acidic conditions in the stomach. But if bilious vomiting continues after using Stomach Soother and it seems to be related to acidity due to an empty stomach consider adding in Nat Phos #10 to your dog's protocol as a natural acid balancer. If chronic vomiting and nausea is an issue combined with liver concerns and perhaps difficulty digesting fats then consider Nat Sulph #11 to help.


Why do I Feel Sick When I am Hungry? Retrieved from

My Dog is Vomiting Bile (What Should I Do?). Retrieved from

Hoffman, D. (2003). Medical herbalism: The science and practice of herbal medicine. Rochester, VT: Healing Arts Press

Kidd, R. (2000). Dr. Kidd’s guide to herbal dog care. North Adams, MA: Storey Publishing.

Puotinen, CJ. (2000). The encyclopedia of natural pet care (2nd ed.). Los Angeles, CA: Keats Publishing.

Pitcairn R. H., & Hubble-Pitcairn S. (1995). Dr. Pitcairn’s complete guide to natural health for dogs & cats. Emmaus, PA: Rodale Press, Inc.


Bilious Vomiting Package for Dogs
Our Bilious Vomiting Package for dogs consists of the three supplements that we consider to form the foundation of our Natural Bilious Vomiting Syndrome Protocol. This supplement package for dogs with bilious vomiting is a research-based protocol developed by a...
from $80.85
Daily Multi Plus for Dogs and Cats
Our Daily Multi Plus is a premier supplement for dogs and cats featuring organic, whole food nutrition. This 3-supplements-in-1 formula was created in response to our clients’ requests to simplify their animal’s supplement regimen and is sure to exceed even...
from $26.95
Stomach Soother Upset Stomach Remedy for Dogs and Cats
Stomach Soother for dogs and cats is a natural remedy for upset stomach or belly ache due to nausea, gas or indigestion. Made with USDA organic herbs and formulated by a certified Master Herbalist, Stomach Soother will help to reduce...
from $24.95
Repair and Strengthen for Dogs and Cats
Repair and Strengthen for dogs and cats has been formulated to help heal the digestive tract and will also support lean muscle growth and maintenance. This formula was created for the many clients we have worked with that have a history...
Herbal Digestive Tonic for Dogs and Cats
Our Herbal Digestive Tonic is a wonderful digestive aid that can really help improve digestion and reduce inflammatory conditions within the digestive tract. It uses organic herbal bitters infused in a menstruum of organic apple cider vinegar to stimulate gastric...
Cell Salts for Dogs and Cats
Dr. Wilhelm Schuessler, a German doctor, established the theory of Biochemic medicine in 1873. Dr. Schuessler combined the principles of biochemistry with homeopathy to give us these 12 natural cell salts, each derived from one of the 12 inorganic mineral...
from $19.99
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