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ChristineLVT, Certified Veterinary Technician
Category: Dog
Satisfied Customers: 3307
Experience:  Licensed veterinary technician (B.S. Mercy College), 10 yrs in animal medicine and training
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Why is my dog vomiting bile a few hours after eating?

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My 7 year old, 44 lbs. mixed breed, started to vomit yellow a few days ago. It wasn't bad at first, as he's done this in the past, usually in the morning. I called my vet, who told me to put him on very small amounts of chicken and rice for a few days. Each time he eats just a tiny amount, a few hours later he vomits the yellow. Initially there were bits of rice mixed in.
The vet then told me to fast him for 24 hours, which I did. He didn't vomit for 24 hours, and then when I fed him the chicken and rice this am, 3 hours later, he vomited again, the yellow with some rice in it.
Vet then told me to come in *staff is on call* and get CLAVAMOX.  I gave him a small amount of chicken. No more than dime sized, and I mashed the clavamox in it. 2 hours later, he vomited again. He's got some gas, now, as well. He had a semi-normal bowel movement this am, after not having one for 24 hours.
How long does clavamox take to work?
My dog is acting normally otherwise. Please advise.

I'm so sorry to hear your dog is sick.

Though I agree antibiotics are a good first defence against stomach illnesses, the antibiotics themselves can also aggravate stomach acid and cause vomiting. It is a catch 22 at times. Seeing as he vomits, more so when the stomach is emptier (thus bile), and has done this at times in the mornings, it is likely he's got some acid reflux which needs attending to in order for this antibiotic to help any bacterial build up. It is often within 3-4 days you notice a difference with an antibiotic, but the antibiotic, like I stated, can add to the problem of vomiting as well.

Try giving some pepcid at a dose of 0.25mg per pound of body weight, as long as your dog has been fairly healthy otherwise (no liver/kidney disease or on heart medications). Then you can try very very small amounts of that bland food, like the boiled chicken or even baby food. Just about a tsp or so.

If he is able to hold down, try again in 2-3 hours this same amount. If doing ok, do this for a few hours, then about 1/2 a meal amount for his next meal time. You can repeat the pepcid in 12 hours as well, if you feel it is needed (while the bland diet helps the most, the pepcid may help speed along the GI's settling).

If doing ok, keep on bland diet for a couple of days, then gradually switch back to normal food. If not able to hold down even the pepcid, he'll need a vet exam sooner than later, as injectable medications will be called for, and further diagnostics may be needed to see if this is more than just a stomach upset. A different antibiotic may be needed, or bloodwork to see if other organs are involved causing this. Also, make sure he's drinking water or even some unflavored pedialyte the entire time so as not to dehydrate (small amounts at a time), and keep him indoors while recuperating, except for short leash walks only to do his business.

Here's some more info about Pepcid. If any concerns, it is always best to check with your vet before giving (you can certainly start the bland diet protocol and add Pepcid later if needed after speaking to your vet). It can be given with clavamox:

Best of luck, hope your dog is better in no time!

ChristineLVT and 2 other Dog Specialists are ready to help you
Customer: replied 9 years ago.

Thank you for responding!
Ok..the thing is, Comanche, my dog, was eating normally up until a few days ago, when the vomiting of bile started. He started to vomit hours AFTER a meal, though most of his meal stayed DOWN!! (in the past, he would vomit bile in the am if he wasn't fed on time).
Lately it was as if, the more he ATE, the more he vomited BILE!! So that could then, possibly mean, acid reflux??
Yes, I realize the antibiotics can make the problem worse. However, Comanche never has had a problem with antibiotics. I've been lucky in that respect. He responds very well to Clavamox, he was on it a few months ago for 2 weeks due to an eye infection, which turned out to be a KCS (he was started on OPTIMMUNE OINTMENT) 2 X daily. He tolerated the clavamox FINE. I do have to wonder, if the Optimmune could have caused all of this??
Another question that I do have is, Comanche was SLIGHTLY underweight. Nothing serious. I figured a few lbs, maybe 5 would be good to gain, and I'd slowly increased his food intake beginning on March 26, 08.
I have to wonder, even though I was spacing the meals out (added a third small meal during the day, if perhaps his stomach could not handle it?? and perhaps that is the cause, the extra food, causing his stomach to overproduce the acid or something of that nature??
In any case, my vet called me at 9:30 tonight, and told me to give him 10 mgs of pepcid. It is nearing 2 am and Comanche has not vomited since. I will keep in mind your mention of baby food, I have a lot of that on hand, for emergencies!!
I also do not do well with math. Could you help me to calculate, what 0.25mg per 1 lb of body weight is?? Does that come out to 10 mgs of Pepcid AC??
Also, yes, I am giving him small amounts of water, at a time:) He has no problem with water. Also, he is acting normal in every other way, and as far as going outside goes, he doesn't like being outside, so he only goes out to use the facilities, so to speak. :)
I'll be up for a little while longer..(I'm on Long Island) and will see if you respond tonight about the dosage of Pepcid Ac.
Again, thank you so much for your concern and caring and for the great information you have given me so far. I will certainly implement it as per your suggestions...and will recheck later or tomorrow for the dosage on the Pepcid.
Thank you again, so much.

You didn't mention how much he weighs? I'd be happy to tell you the dose I recommended.

I think if the food was too much with the increase, he'd be regurgitating. I do think the build up of stomach acid is causing this, why it is doing so is the concern. While treating like this may help (so glad he hasn't vomited as of now) and it may be the end of your worries, if it does not, and together with his being underweight, I wonder if there is a physiological reason for him possibly digesting either too fast causing this, or the body is overdoing it with digestive enzymes (bile is one) to break down the food. This could be a symptom of pancreatitis or other digestive problem. The added food could certainly make a diseased pancreas "worked up" enough to cause this. It certainly doesn't sound severe enough for him to need any hospitalization but some bloodwork may give you that answer and your dog may need a different special diet to help control future problems if that is the case.

I don't see how the optimmune would cause this problem.

Let me know his weight, 10mg would be the dose for a dog around 40 lbs. I would stick with the vet's dosing if it is off though.

ChristineLVT and 2 other Dog Specialists are ready to help you
Customer: replied 9 years ago.

Good morning, and thank you!
His weight is 44 lbs (I mentioned it in the first line of my post, you probably didn't see it!!)

I thought so, about if it were the food, he would be regurgitating. As for his food, he usually eats Wellness Duck and Rice, which is bland, and my vet recommended me watering it down, to aid digestion, due to the nature of explosive diarrhea problems when Comanche was younger. Changing to this food and watering it down, made all the difference. He has bloodwork yearly, but yes, will definitely follow with bloodwork and a vet assessment!
By the way, Comanche did not vomit since yesterday. 6pm. He also had a tsp of chicken/rice this am and is doing well.
I'll look for your dose of Pepcid-he's 44 lbs.
Again, thank you so much.

You did mention the weight! Sorry about that, I was reading your second post when I answered that. 10mg is a correct dose (technically, 11mg is the exact, but basically impossible to dose, so you'd go with 10mg).

I'm so happy to hear Comanche hasn't had additional vomiting episodes - I hope this is the sign he's getting back to normal.

Best wishes, and if you get a chance, I'd love to hear how he got his name, it's very unique!

Customer: replied 9 years ago.

Thank you so so VERY much!! ah, 11 mgs would be "the dose" but yes, impossible to do that!! It has now been a full 24 hours, no vomiting, so he's been eating a tsp of food every 2 hours (rice/chicken) and holding well:)
Comanche got his name because he was quite ill when I decided to adopt him from a shelter 7 years ago. He was 5 weeks old, was extremely ill, and was definitely taken from the mother too soon. I had to save him. He's a survivor, very strong, and just like this horse, Comanche:
Comanche (the horse) was a mixed Mustang Morgan horse who survived General George Armstrong Custer's detachment of the United States 7th Cavalry at the Battle of the Little Bighorn.
He was bought by the U.S. Army in St. Louis, Missouri and sent to Fort Leavenworth, Kansas. Captain Myles Keogh of the 7th Cavalry liked the 15 hand bay gelding and bought him for his own personal mount, to be ridden only in battle. In 1868, while fighting the Comanche in Kansas, the horse was wounded in the hindquarters by an arrow, but continued to let Keogh fight from his back. Thus the horse was named “Comanche” to honor his bravery. Comanche was wounded many more times, always exhibiting the same toughness.
And that is the story of how MY Comanche got his name!!
I would like to tell you the results of the bloodwork that Comanche is having tomorrow, to update you as you've been so caring and helpful!!

Wow, that is an amazing story and an appropriate name. Thank you so much for sharing it.

Customer: replied 9 years ago.

Yes, the name Comanche really fits my boy!!! He's doing GREAT. He wants more chicken and rice. I think he's learned to tell time, he knows when it's time for more..
You have been so helpful, and really helped me a lot. I appreciate your taking the time to do this!!!!
Thank you so very much!

Looking forward to more good news.

Take care

Customer: replied 9 years ago.

Wanted to give you an update. This morning, when Comanche got up, after he urinated, he became sort of dizzy. He seemed shaky on his feet, and looked dizzy. I petted him and then gave him some water, then fed him....and he's been alright.
I forgot to mention, that something similar happened a few days ago, it was the same thing, after a 24 hour fast. I wonder if he's weak from lack of regular food?
Vet was here today, did full blood work up, felt his abdomen, took a faecal, and I'll have the results on Thursday. Vet also gave sub-q fluids, he felt it would help boost him a bit. He wasn't dehydrated, but might have been on the way.
I wonder, do you think that the wobbly dizzy episodes could have been related to lack of food, as they only occurred in the MORNING after waking up, and once he ate, every thing was fine.
After a great day yesterday, I was fraught with worry today.......
Thank you for all your help.

This sounds just like hypoglycaemia (low blood sugar), which does occur when not having had a meal for some time. It fits with the theory above about digesting so quickly and then having a mostly empty stomach for vomiting bile. Hypoglycaemia can be easily prevented in healthier dogs who show symptoms by feeding more meals throughout the day. The amount doesn't necessarily have to increase, (though you may want to with his underweight issue) but the number of times having his daily ration should increase. Yes, this can be difficult in the early am, so best bet there is to always have some karo syrup on hand, and if for any reason he appears dizzy and doesn't eat right away, you can place a small amount of syrup on his gums, which will give him a sugar boost.

Customer: replied 9 years ago.

Thanks for the quick reply.
So, even though Comanche did eat those small meals yesterday, (very small, the tsp. of chick/rice every hour or so,) it probably wasn't enough to keep his sugar up, thus causing the dizzy episode only in the am??
Thank you again.

Small meals get digested rather quickly which is why frequency is important. But I think your dog seems to digest a little quicker than many, with the vomiting of bile so shortly after eating (usually 4 hrs post eating a small amount of food may be seen still). So in the morning, the last couple of small meals from the night before likely weren't much to keep his sugar boosted. Make sure your vet is aware of this occurrence with the dizziness. Digesting quickly and symptoms of hypoglycaemia may be related and there may be further things your vet could look into in the future for helping this acid problem and possible difficulty of gaining weight.

ChristineLVT and 2 other Dog Specialists are ready to help you
Customer: replied 9 years ago.

Thank you for clarifying this for me, it's helping me to understand things better.
Yes, my vet is aware of the dizzy spell that he had after the 24 hour fast, and then the small one he had this am, just before he ate.
I just wanted your opinion as well, being that you've been spot on about the Pepcid Ac, which my vet agreed was a great idea, as well.
Thank you also for the Karo syrup suggestion.