Hi again Pam,
Sorry for the delay - kids are a bit wingy tonight!
You have described to meCustomer who is an 8 year old Maltese who has recently been treated by his veterinarian for gastroenteritis. He was treated with an injection, and with antibiotics and carafate. He finished all his medications, and is back onto his usual food, but today seemed nauseated for 3 hours before finally vomiting up bile.
There are a number of things that could be going on with Biscuit, but from what you are describing it sounds as though his intestines are not back to 100% after his illness.
So, the vomitus today sounds like it was bile (this usually appears yellow, green or orange in colour, and foamy). The stomach makes acid and mucus, and the gall bladder makes bile, which flows down the bile ducts and into the small intestines, just below the stomach. Bile is orange, yellow, or even greenish!
When a dog vomits bile, it tells me that the stomach is very empty, and there is nothing to absorb the bile. In Biscuit, I suspect he may have "bilious vomiting syndrome." Don't worry - it's not as horrible as it sounds!
Basically, in small dogs their stomachs are tiny and their metabolisms are fast. They use up the food in their stomach very quickly, and then their stomach is empty. The stomach contains gastric acid, which is very irritating to the stomach lining, especially when there is no food to soak it up. When the stomach is empty, the acid irritates the stomach so much that the dog starts to feel nauseated. Then, he won't eat. So, the stomach remains empty and irritated. The dog then vomits - and it is stomach acid and bile that comes up!
So, it becomes a cycle - empty stomach --> nauseated --> vomit --> nauseated and so on.
The way to break the cycle is to get Biscuit eating many many small meals. Sometimes we have to give dogs with this problem an antacid to help them - common options are cimetidine (Tagamet), famotidine (Pepcid) or ranitidine (Zantac). When I see dogs and diagnose them with this problem, I often put them on famotidine (pepcid) that I have the owners buy at the local pharmacy.
Here is more about Tagamet:
More about Pepcid, including dose:
And more about Zantac:
Keeping Biscuit's stomach from getting empty will also help to break this cycle. This is particularly true of a bed-time meal. He needs to have something just before going to sleep in order to prevent his stomach from getting so empty overnight.
Also, it is *really* important that he eats very soon after waking in the morning. Breakfast really is the most important meal of the day, so that we can get that stomach acid soaked up in some food and prevent the stomach from getting irritated. So, even if you have to resort to a bit of bread or low-fat crackers, then do that to get him to eat.
The other thing that I would recommend if Biscuit were my patient would be to put him on some Culturelle probiotic. You are lucky to live in the USA because it is widely available there in pharmacies! Here is more: www.culturelle.com
. In a dog the size of Biscuit, he would get about 1/2 capsule twice daily mixed in with his food. This will help to restore the "good" bacteria to his intestines. The yogurt you gave will help, too (make sure it has no artificial sweeteners in it!).
So, in summary, it sounds to me that Biscuit vomited bile and stomach acid because his stomach got irritated from being empty for long periods, and because it has not 100% recovered from his Christmas gastroenteritis. If he were my patient, I would treat him by giving culturelle, by giving frequent small meals and by giving antacids if needed.
Here's a link:
If getting your dog to eat breakfast is a challenge, you could try canned easy-to-digest foods from your vet (I/D or Gastro are a couple of brands) or pick up some jars of human baby food. Just make very sure the baby food has no onions, onion powder, garlic or garlic powder in it. Beech
I hope that this has been helpful. If it has, please hit the green "Accept" button and leave feedback.
I will still be here to provide more information if you need it!
The above is given for information only. Although I am a licensed veterinarian, I cannot legally prescribe medicines or diagnose your pet's condition without performing a physical exam. If you have concerns about your pet I would strongly advise contacting your regular veterinarian.