Gastrointestinal foreign bodies were removed surgically from a 9-year-old Siamese cat. Two days later the cat became lethargic and started regurgitating. A degenerative leukocytosis and drop in packed cell volume were present. Gastric wall thickening with intramural gastric air was detected radiographically and sonographically. Gastric ulceration with a focal necrotic area was seen endoscopically. At surgery, the stomach wall was emphysematous. Clinical signs resolved following partial gastrectomy and medical management. Intramural gastric air with declining clinical course was a significant impetus to return to surgery.