Gastrointestinal signs are common in dogs with uremia. Structural changes in the stomach associated with uremia in dogs include ulceration, edema, necrosis, gastric wall thickening, submucosal arteriopathy, and mineralization of the gastric mucosa and submucosa. Upon ultrasonographic evaluation of the abdomen in four dogs with severe uremia due to chronic renal disease, a thickened gastric wall, thickened rugal folds, and a hyperechoic line at the mucosal‐luminal interface due to mineralization of the gastric mucosa were found. Ultrasonography was more sensitive than survey radiography for the identification of gastric lesions associated with uremia in these dogs.