Dear Dr. John,

Our 14-year-old Yorkie is in an ICU. About three days ago, he started vomiting with yellow bile. What causes a dog to vomit bile? He kept drinking lots of water and that came up as well. He seemed to lose all interest in food and after two more days of not eating and starting to look weak, we took him in. Initial bloodwork showed elevated kidney values. Can that come on suddenly and why? Bloodwork six months ago was totally normal! According to the emergency hospital, he is on the mend, the values are improving, and he is now eating some. What are the odds of a relapse since he is a senior citizen? D.F.

Dear D.F.,

It sounds as if you were wise to bring him into the hospital when you did. Bilious vomiting can come on for various reasons. The most common cause, when seen in the early morning, is due to an empty stomach and bile coming into the stomach causing irritation and vomiting. Other causes include pancreatitis, inflamed proximal bowels, cancers, eating inappropriate or spoiled foods, and more. Various toxins and getting into garbage might also lead to this.

Your dog was drinking more water to try and maintain hydration but once the stomach is irritated enough to keep vomiting, a cause needs to be identified, and medications are needed to stop the repeated vomiting. Also, a dog will not eat if they are continuously nauseous. If bloodwork showed elevated renal values, I cannot help but wonder if the dog got into something. Only you and your family would possibly know that. Even though his bloodwork looked normal six months previously, sudden onset or acute renal failure can happen in an old dog for no apparent reason other than age and result in bilious vomiting.

I am sure that the hospital is doing all that they can to give him plenty of intravenous fluids to flush out his kidneys and bring the values down. This will help with the nausea. His starting to eat is a good sign and hopefully things will continue to normalize. It is impossible to know if he might relapse. Good luck!

Dr. John de Jong is President of the World Veterinary Association. He owns and operates the Boston Mobile Veterinary Clinic and can be reached at 781-899-9994.