– 11 year old MN Shih Tzu with a chronic history of inteminttent vomiting (bile, foam) and signs consistent with possible GER

– pet has been treated with sulcrate, omeprazole, metoclopramide but has never really gotten better. The owners said the patient did better when placed on a trial of baytril and clavamox

– abdominal ultrasound showed a gastric wall thickening at the pylroic outflow which appeared to affect primarily the mucosal layer; there are odd hyperechoic striations in the mucosa here

– 11 year old MN Shih Tzu with a chronic history of inteminttent vomiting (bile, foam) and signs consistent with possible GER

– pet has been treated with sulcrate, omeprazole, metoclopramide but has never really gotten better. The owners said the patient did better when placed on a trial of baytril and clavamox

– abdominal ultrasound showed a gastric wall thickening at the pylroic outflow which appeared to affect primarily the mucosal layer; there are odd hyperechoic striations in the mucosa here

– endoscopy revealed a raised, hyperechoic mass-like lesion and biopsies were taken

– histopath indicated pyloric mucosal hypertrophy (possible pyloric stenosis) however a hyperplastic polyp can not be ruled out from the description I gave the pathologist

Any thoughts on the ultrasound images? The lesion appears more circumferential on ultrasound but seems more polyp-like on endoscopy.  I suspect that this is the reason for the patient’s chronic vomiting. Not sure where to go from here?