Ultrasonographic features of gastric mucosal hypertrophy in dogs receiving chronic omeprazole: a retrospective case series.

Chronic omeprazole produces characteristic gastric mucosal hypertrophy pattern on ultrasound.

This retrospective case series describes characteristic ultrasonographic features of gastric mucosal changes in nine dogs receiving chronic omeprazole therapy (≥5 months). Dogs were medium to large breeds treated with omeprazole for portosystemic shunting, gastric ulceration, or chronic enteropathy. Ultrasonographic findings consistently demonstrated mucosal-predominant gastric wall abnormalities localized to the gastric body and fundus, characterized by hyperechoic, mildly heterogeneous mucosa with undulating margins and thickened rugal folds. Seven dogs showed circumferential involvement while two had focal changes. Four dogs exhibited small intramucosal hypoechoic to anechoic round structures. Wall layering remained preserved in eight dogs without regional lymphadenopathy or perigastric abnormalities. Histopathology from four dogs confirmed PPI-associated hypertrophic mucosal phenotype with mucous neck cell hyperplasia. These findings suggest chronic omeprazole administration produces a consistent, recognizable ultrasonographic pattern that may help differentiate medication-associated changes from more serious pathology such as neoplasia, severe gastritis, or hemorrhage, potentially reducing unnecessary diagnostic investigations.

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