Bilious Vomiting Syndrome In Cats Treatment

Bilious Vomiting Syndrome In Cats Treatment: Bilious vomiting syndrome in cats occurs when a cat’s stomach is empty for an extended period, leading to vomiting of bile.

Bilious Vomiting Syndrome In Cats Treatment

As a cat owner, it’s important to understand what causes this condition and how to properly treat it.


The most common cause of bilious vomiting in cats is prolonged fasting or irregular feeding times. Cats are grazers by nature and have small stomachs, so they do best with multiple small meals throughout the day instead of one big feast.

When a cat goes too long without eating, bile builds up in the stomach and gallbladder, which can lead to nausea and vomiting.


The hallmark symptom of bilious vomiting syndrome is yellow, bile-stained vomit, usually in the morning. Your cat may vomit multiple times in a short period.

Other symptoms include lethargy, decreased appetite, and excessive salivation. Bilious vomiting is usually not accompanied by diarrhea or other signs of illness.

Diagnosis and Treatment

Diagnosing bilious vomiting syndrome is usually straightforward based on symptoms, medical history, and by ruling out other conditions. Treatment focuses on preventing prolonged fasting and regulating your cat’s feeding schedule. It may help to:

  • Feed your cat multiple small meals throughout the day instead of one large meal.
  • Don’t leave more than 6-8 hours between feedings.
  • Make sure your cat has access to food overnight.
  • Provide your cat with interactive feeding toys to keep them engaged and extend feeding times.

By making simple changes to your cat’s feeding routine and schedule, bilious vomiting syndrome can often be well managed.

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However, if symptoms persist for more than a couple of days or your cat shows signs of dehydration, consult your vet. They may want to run some tests to check for any underlying conditions.

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Common Symptoms of Bilious Vomiting Syndrome

If your cat is exhibiting bilious vomiting, they may show the following symptoms:

Excessive Vomiting

  • The most prominent symptom is frequent vomiting, often occurring in the early morning before eating. The vomit typically contains yellow or green bile, which gives this condition its name. Cats may vomit 2-3 times per week or up to once daily.

Loss of Appetite

  • Since the stomach is empty during the night and early morning, the buildup of bile can lead to nausea which causes a decreased appetite. Cats may seem disinterested in food or only eat small amounts.

Weight Loss

  • Due to decreased appetite and calorie intake from frequent vomiting and nausea, cats with bilious vomiting syndrome may suffer from mild to moderate weight loss over time. Weight loss can become a medical concern if persistent, so monitoring your cat’s weight at home is recommended.


  • Excessive vomiting and loss of appetite can result in dehydration, electrolyte imbalance, and lack of energy. Your cat may seem less active or playful and sleep more frequently. In severe cases, lethargy can indicate additional medical issues and veterinary care is needed.

If your cat is displaying symptoms of bilious vomiting for more than a couple of days, especially loss of appetite, weight loss, or lethargy, consult your vet.

They can examine your cat, run blood tests to check for any underlying conditions, and determine an appropriate treatment plan to get their vomiting and appetite back to normal and prevent any serious complications.

With prompt diagnosis and treatment, the prognosis for bilious vomiting syndrome is typically good.

Treatment Options for Bilious Vomiting Syndrome

If your cat is diagnosed with bilious vomiting syndrome, the good news is there are several effective treatment options available.

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The course of treatment will depend on the underlying cause of the excess stomach acid and bile.

Dietary Changes

Making some adjustments to your cat’s diet may help reduce bilious vomiting episodes. Feeding your cat multiple small meals throughout the day instead of one large meal can help prevent the buildup of bile and stomach acid.

You should also avoid giving treats in between meals. Feeding a high-protein, low-carb diet may also be beneficial for some cats. Changing to a easily digestible cat food formulated for sensitive stomachs may provide relief for bilious vomiting caused by dietary intolerances.


In some cases, medications may be prescribed to reduce stomach acid, control nausea, and promote stomach emptying. Antacid medications such as famotidine or omeprazole can help reduce stomach acid.

Metoclopramide may be used to increase stomach emptying and reduce nausea. Ondansetron is an anti-nausea medication that can provide relief from vomiting. These medications are often prescribed to use as needed when bilious vomiting occurs.

Lifestyle Changes

For cats prone to anxiety or stress-related bilious vomiting, lifestyle changes may help. Providing extra playtime, affection, and interactive toys can help relieve anxiety in some cats. Using Feliway sprays or diffusers can have a calming effect.

Feeding your cat at the same time every day and limiting late night snacks or feedings can also help establish a regular feeding schedule to prevent buildup of bile and stomach acid overnight.

If bilious vomiting persists despite initial treatments, further testing such as blood work, imaging, or endoscopy may be recommended to determine if an underlying condition is present.

With the appropriate treatment plan tailored to your cat’s needs, bilious vomiting syndrome can often be well-managed. By closely following your vet’s recommendations, most cats experience significantly fewer episodes of vomiting and are able to maintain a good quality of life.

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What causes bilious vomiting in cats?

Bilious vomiting in cats occurs when a cat has an empty stomach and bile builds up, leading to vomiting. Bile is the digestive fluid produced by the liver and stored in the gallbladder.

When the stomach is empty, bile can irritate it and trigger vomiting. This often happens early in the morning before eating, due to the long overnight fast.

What are the symptoms of bilious vomiting syndrome in cats?

The primary symptom is vomiting yellow, bile-stained fluid, often on an empty stomach. Your cat may also experience decreased appetite, lethargy, and weight loss.

Repeated bouts of vomiting over time can lead to dehydration if not properly treated. It’s a good idea to consult your vet if your cat is showing these symptoms.

How is bilious vomiting syndrome diagnosed?

Your vet will diagnose bilious vomiting syndrome based on your cat’s symptoms and medical history. They will perform a physical exam to check for any abnormalities and may run blood tests or other diagnostics to rule out underlying issues. An ultrasound or endoscopy may also be recommended in some cases.

How is bilious vomiting syndrome treated?

The most common treatment is to feed your cat multiple small meals spread throughout the day instead of one large meal. This helps prevent buildup of bile and irritation of the stomach. Your vet may also prescribe:

  • Antiemetic medication such as chlorpromazine or metoclopramide to reduce nausea and control vomiting.
  • Stomach acid reducers such as famotidine or omeprazole to decrease stomach acid and protect the stomach lining.
  • IV fluids for dehydration in severe cases.
  • Dietary changes using a bland, highly-digestible diet until symptoms improve.

In most cases, bilious vomiting syndrome can be well-managed with lifestyle and dietary changes as well as medication.

However, it’s important to have your vet examine your cat to determine the underlying cause of symptoms and the appropriate course of treatment. With consistent care and monitoring, bilious vomiting can typically be resolved.

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