The 2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats emphasize the role of opioids in the perioperative space noting they are the most effective drug class for managing acute pain and therefore should be used routinely as part of the preoperative analgesic protocol.[1] However, there may be undesirable effects when using this class of drugs, including acute emesis. A commonly used medication, maropitant citrate, is the first and only FDA approved medication for the prevention of preoperative vomiting in dogs given emetogenic agents such as opioids.