Hunger Pukes & the Rest

Welcome back, Newlings.

If you share your life with a dog, and especially a sensitive-tummy one like Maverick, you'll know that being sick is part of the territory. It's never nice to see. That first instinct is always a little flutter of worry: is this normal, or is something wrong?

This is the calm, owner-to-owner guide I wish I'd had early on. The common types of dog sick, what they can mean, and (the important bit) when it's a "keep an eye on it" versus a "ring the vet now."

First, the one we know well: the "hunger pukes"

If you've ever been woken at 5am by that unmistakable retching sound, only to find a little puddle of yellow or white foam, congratulations: you've met the hunger pukes.

They happen on an empty stomach. When a dog goes too long without food, bile (a yellow digestive fluid) and stomach acid build up with nothing to act on. That irritates the stomach lining and comes back up, usually frothy and yellow or white, often first thing in the morning or last thing at night. It's sometimes called "bilious vomiting syndrome," but "hunger pukes" says it better.

Maverick, with his delicate tummy, has had his share. A few things have genuinely helped us, all worked out with our vet. We keep a smaller gap between his evening food and breakfast, and he usually has a little something before bed to settle his stomach overnight. Mostly it comes down to not leaving him running on empty for hours on end.

The hunger pukes usually aren't an emergency on their own, but frequent vomiting of any kind always deserves a vet's eye. "He's just hungry" shouldn't become the automatic explanation for something that might need looking at.

A little more on the “why” (the bile bit)

Here's the part I found genuinely helpful to understand, because it's so relevant to Maverick. Bile acid is made by the liver, stored in the gallbladder, and released into the gut when food arrives to help digest it. Fat especially needs plenty of bile. The liver is the manager here: it decides how much bile to produce, and food is the trigger. So the puzzle is why some dogs bring up bile when their stomach is empty, and the honest answer is that it's usually diet-related, and often a bit of trial and error to pin down. Essentially, the body over-produces bile that then has nothing to do, sits in the gut, and comes back up.

There are a few common culprits worth knowing about. The first is fat level. Too much fat can over-stimulate the liver, but oddly the opposite can happen too, where a dog used to richer meals gets a leaner one and brings up the unused bile hours later. The second is the move from kibble to raw. In the early days the liver is still producing lots of bile to cope with kibble's high carb content, and with the carbs suddenly gone, that extra bile has nothing to bind to. This usually settles as the liver adapts, and easing the transition with a few fruits and veg in the first days can help.

So if the bile pukes are frequent, play detective. Note when they happen: the time of day, how many meals, how long on raw, and whether a particular protein, fat level or carb content seems to line up. If you genuinely can't find a dietary pattern and it keeps happening, that's the point to have your vet check liver function with a simple blood test, because persistent bile vomiting with no dietary cause can occasionally point to a liver issue. There are liver-support diets and supplements that can help if so.

A calm guide to the other types

Dog sick comes in a surprising range of colours and textures, and each can hint at what's going on. This isn't to turn you into a worrier. It's so you can tell, calmly, whether it's a watch-and-wait or a pick-up-the-phone.

Yellow or green (bile). The hunger-puke colour. An empty stomach, or sometimes after eating grass. An occasional one is usually nothing, though frequent episodes point to digestive upset worth investigating.

White and foamy. Saliva and air, often from acid reflux, indigestion or an empty stomach. Once or twice is usually minor. But repeated foaming, especially with a swollen tummy, restlessness, or trying to be sick with nothing coming up, can signal bloat, which is life-threatening. Don't wait on that one.

Clear or liquid. Often just water or saliva, sometimes from drinking too fast, sometimes mild nausea. Usually mild, but keep an eye on it.

Slimy or mucus-like. Mucus from an irritated stomach lining. It can follow eating something they shouldn't have, like grass, bin raids or spoiled food.

Brown or chunky. Frequently just partly-digested food, often from eating too fast. But dark-brown or foul-smelling sick can occasionally mean a blockage or something more serious, so trust your nose and your instincts.

Bright red or pink. Fresh blood, from the mouth, throat or stomach. This is a vet emergency.

Dark red, black, or like "coffee grounds." Digested blood from higher up the digestive tract. Go to your vet immediately.

What we actually do (with our holistic vet)

So here's how we handle Maverick's episodes, with one big caveat: this is what works for one dog, built up over time with the guidance of several vets. It isn't a protocol to copy. Every dog is different, so please run anything here past your own vet first. I'm planning a much more detailed post on the specific protocols we've developed for different ailments, so treat this as just the overview.

For yellow/bilious or white foamy sick (the hunger-puke type), my first step is a small snack within about half an hour. That might be a raw duck wing, a dehydrated ostrich foot tendon, or a little raw meat with bone broth for hydration. Whether he takes it tells me a lot. If he eats, that's reassuring; if he refuses, I know to look closer. Depending on his symptoms and the time of day, our vets have guided us on homeopathic remedies, usually aconite, arsenicum album or nux vomica. Then I'll try his normal meal at his usual time. We've moved to one main meal between 1 and 4pm now, with bones and chews around it rather than two set meals. If he eats and holds it down, I watch him for 24 hours and check his stool, and if that's normal, all's usually well. If it isn't, I keep watching for a day or two, and if it carries on I'll run a Wormcount test and a stool sample screening for parasites, bacteria, viruses and gut-microbiome markers.

Sick that comes up later with food in it is trickier. For Maverick, with his history, persistent episodes can point to something like Giardia or a clostridial upset, which is a very different situation, or a reaction to something he's eaten or licked on a walk. A one-off I watch and support at home. But if it carries on over a few days, that's when I step things up. I have a particular at-home protocol I work through first (that's coming in the detailed protocols post), and if things don't settle, we'll see our vet for a blood test to check liver and kidney markers. One genuinely useful thing to know for that stage: vomiting itself can temporarily raise certain liver markers, so our vet often repeats the bloods about 10 days later. If they've come down, it's reassuring, and usually means the stress of the vomiting caused the blip rather than anything ongoing.

Two things I'll never be without, both used under proper guidance: Saccharomyces boulardii (a probiotic yeast that's been wonderful for his gut) and homeopathic remedies when used correctly.

I'll go much deeper into all of this in a dedicated post: the specific remedies, when to use what, and the step-by-step protocols. Save or follow along for that one.

When to stop watching and call the vet

Colour aside, these are the signs that mean don't wait:

If you're ever unsure, ring your vet. A phone call costs nothing, and a good vet would always rather hear from you than have you sit at home worrying.

The Newling takeaway

A one-off sick with a bright, bouncy dog afterwards is usually just one of those things. What you're watching for is a change from their normal: more often, more unwell, or any of the red flags above.

For us, understanding the hunger pukes took a lot of the 5am panic out of them. If anything it made me more attentive, not less, to the times something isn't routine.

As always, this is general, natural, owner-to-owner information, never a replacement for your vet. When in doubt, always check with them.

Here's to growing well, together.

— Caroline & Maverick