Acid Reflux, Bilious Vomiting, Fasting and Hunger Pukes in Dogs | ProDog Raw

Acid Reflux, Bilious Vomiting, Fasting and Hunger Pukes in Dogs


by Nick Thompson

Heidi at Prodog Raw is a real research hound. She’s asked me to gather information on Acid Reflux in dogs. They are getting a lot of enquiries about this issue from people feeding kibble.

Looking around the internet, there’s loads of info on it, as there is for every possible thing you can imagine. There’s loads of stuff out there, half of it contradicting the other half, as usual. This means it’s difficult to decide what’s what and what to do. I decided to research the topic and distil everything into this blog, so you can see the guts of the subject, as it were.

The Disease GERD

Acid reflux or GERD (Gastroesophageal reflux disease) is basically where, for various reasons, highly acidic stomach juices slosh or flow up into the gullet, the oesophagus. It’s the pipe connecting our mouth and throat to our stomachs – quite a helpful tube, I think you’ll agree.

Acidic juice, hitting this rather important mucus membrane tunnel, as you can imagine, causes damage. Erosions and ulcers, inflammation and damage ensue. If there is sufficient damage, scar tissue can eventually form, even if the problem is addressed promptly. Best to avoid in the first place, methinks.

The Video on GERD

On my internet travels, I discovered this fantastic, short (7 minutes and 26 seconds) video on YouTube by the wonderful and ultra-well-informed Dr Karen Becker on GERD. She encapsulates everything you need to know on the subject. Haha! Thanks, Karen. Saved me two days of writing. Excellent.

A Few Points to Watch

I don’t agree with everything she says, though. Most of the info is spot-on, but just be careful where she says to use food allergy testing to see what foods your dog might hypersensitive to? Most vets and vet nutritionists agree these tests are, at best, a guide to what to feed and what to avoid. Don’t take them as gospel.

Karen mentions Hypochlorhydria (lack of stomach acid), rightly, as a cause of GERD. However, I would emphasise her warning that giving extra acid to a dog with GERD is potentially dangerous and should only be done when you have a definitive diagnosis from a vet.

She mentions fluoride-free water possibly contributing to GERD. This is pretty common in the USA, but less so in the U.K. Wikipedia tells me only 14% of U.K. households receive fluoridated water. The rest has sufficient natural fluoride to come up to the World Health Organisation’s recommendation of one and a half parts fluoride per million parts water. If you live in ‘parts of Bedfordshire, North Nottinghamshire and Lincolnshire’, you may receive fluoridated water. Best to check if you have a dog with GERD.

Chiropractic is mentioned in the video as helping some cases of GERD. I agree entirely but would add that Osteopathy can also influence GERD and other gut motility disorders. How can this be? Because the gut’s motion and contractions are influenced by nerves coming from the brain (the Vagus nerve, so-called because it wanders from the brain down into the abdomen – from the Latin’ vagary’ meaning to wander – as in vagrant, vagabond or vague all come from the same root – just thought you’d like to know). Nerves from the spinal cord (spinal nerves) also modulate gut activity and, if ‘pinched’, can change gut function – anywhere from the mouth to anus—fantastic anatomical stuff, and an important area to cover if you have a dog with GERD.

A Few Things Not Mentioned in the Dr Karen Becker Video

Bilious Vomiting Syndrome (BVS)

BVS is really common. I speak to people about it daily. It’s usually straightforward to fix, too. If your dog regularly, or infrequently, vomits bilious (yellowish or clear mucus from the stomach) early in the morning, this may be BVS. The treatment is simple – feed them a meal (not just a treat) just before bed. Dr Becker mentions that this can exacerbate GERD, so if you do it and your dog has more reflux at night, stop, think again and talk to your vet. I’ve never seen it happen, but I mention it for completeness.


Attractively named Hunger-Pukes are where dogs vomit if left without food for more than a few hours. If you can’t solve this by more frequent feeding, have a chat with the vet.

Hunger-pukes do raise the question of the timing of meals, though. A fascinating subject that we can look at here, briefly. If you feed your dog at exactly the same time each day, you can imagine that the few hours preceding the meal will be filled with growing excitement at the prospect of some grub. I think some dogs get into such a lather at the prospect of food that their stomachs churn and squelch so much that they induce vomiting. The cure? Don’t feed at regular times.

If you’re moving from regular feeding, as most people do, say, eight in the morning and six at night, the best way to move initially is to feed a bit earlier. If you feed later, you may go into hunger-puke territory.


Fasting, in human nutrition, is rapidly becoming very popular. It’s been used for aeons in traditional medicine and, for a long time, until recently, has been unpopular in the West. Nowadays, Intermittent Fasting (read Dr James Fung, The Obesity Code for details), where one doesn’t eat for fourteen to sixteen hours a day, is very popular among people trying to lose weight or improve their health.

For our canine friends, it’s the same – it can help with general health and obesity. It’s simple – some people just avoid solids for one day a week or fortnight. They, of course, ensure access to clean water during the fast. Some offer a second bowl (N.B. – in addition to the regular water bowl) with a smidge of honey and a little natural salt in water (¼ tsp of each per litre of water in the bowl). Bone broth can be offered in the second bowl, either straight or diluted.

Other owners do the intermittent fasting thing and feed the dog all their food in one go in the afternoon. This is my favourite method, although I agree with Juliet De Bairacli Levy that periodic regular fasting is very beneficial. If you have a deep-chested dog like a Dane or an Irish Setter, you’d best take advice from your vet.

If you’re going to start fasting your dog, that’s great. The important thing is to change slowly. Gradually, over 2-4w, reduce breakfast and put that food portion into the afternoon/evening meal. If you change suddenly, you will not be popular with the dog and could induce hunger-pukes.


Watch the video by Dr Karen Becker first, then ponder what we’ve discussed here in the blog. You’ll be better informed, and you could make a substantial difference to your dogs’ gut health.

It’s interesting to note that maybe the most important thing about feeding might be NOT feeding and WHEN you feed—food for thought.

Nick Thompson

BSc (Hons) Path Sci., BVM&S, VetMFHom, MRCVS. Founding President of the Raw Feeding Veterinary Society. Petplan Vet of the Year Nominee 2009, 2015, 2017, 2018 & 2020. The practice of the Year Nominee 2018.


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