A 10-year-old male castrated Shih Tzu was presented to Cornell's Emergency Service in June for a two-day history of vomiting and abdominal pain. Conservative management with fluids and pain medication failed to improve his symptoms, so the patient was referred to Cornell for further diagnostic work up. The patient was admitted by the Emergency service, treated with supportive care (intravenous fluids, anti-emetics and gastroprotectants) overnight, and transferred to Internal Medicine the next morning. Physical exam was largely unremarkable other than a historical grade IV/VI heart murmur and severe abdominal pain on palpation. Blood was collected and submitted for CBC/Chemistry, which revealed a mild anemia, neutrophilia, hypoalbuminemia, and mildly increased AST and ALP. A baseline cortisol was submitted and was within normal limits. A SNAP® cPL™ was negative thus ruling out pancreatitis, and a urinalysis was performed which revealed isosthenuria, presumably due to fluid therapy. Radiographic examination of the abdomen revealed no evidence of gastrointestinal obstruction or other abnormalities. Abdominal ultrasound revealed a small, well-defined mural mass protruding into the lumen of the stomach presumably on the lesser curvature close to the junction of the body and fundus of the stomach. The mass was heteroechoic with a small amount of vasculature noted via Doppler exam. Stomach wall layering was absent in the region of the mass. A small nodule was also detected on the tail of the spleen. A brief echocardiogram was performed to investigate his murmur prior to possible surgery, which revealed mild left atrial enlargement and mitral regurgitation. The patient underwent an abdominal exploratory to surgically resect the gastric mass and the splenic mass. Histopathology revealed a gastric leiomyoma with ulceration and necrosis, and splenic nodular hyperplasia with vascular ectasia. The next morning the patient was noted to be much less painful. He was discharged to the care of his owner two days after surgery on pain medication, gastroprotectants, and incision care instructions. His recovery was uneventful and his symptoms resolved following resection of the mass.