What Is Bile Vomiting Syndrome?

Bile vomiting syndrome is a digestive condition likely caused by gastroduodenal reflux. It occurs when a cat’s stomach remains empty for extended periods, particularly when fed only once daily. This issue can affect cats of any age or sex and generally occurs in otherwise healthy animals. However, underlying gastrointestinal diseases—such as partial obstructions or chronic gastritis—may increase the risk.

Vomit typically contains bile, a yellowish fluid, and episodes most often occur late at night or early in the morning before the first meal. This syndrome may be confused with other digestive conditions, making accurate diagnosis essential.

Diagnosis and Additional Testing

During a clinical exam, no significant abnormalities are usually found. Blood tests and abdominal X-rays generally return normal results. In some cases, a gastroduodenoscopy may be recommended to rule out inflammation or obstruction of the pylorus, although this procedure is not always required.

Treatment for Bile Vomiting Syndrome

Dietary Modification

• Divide the daily food portion into several small meals.
• Offer a late-night snack to prevent prolonged fasting.

Prokinetic Medication

• If vomiting persists, medications that promote gastric motility may be prescribed. These help reduce reflux and speed up stomach emptying.

Anti-emetic Medication

• Maropitant (Cerenia, Emevert) helps prevent vomiting and nausea. It can be administered subcutaneously or as oral tablets, with a 24-hour duration of action.

Prognosis

With dietary adjustments and appropriate medication if needed, most cats respond very well to treatment. Early intervention helps minimize vomiting episodes and improves long-term digestive comfort for your cat.