Retrospective Analysis of Compulsive-like Long-Standing Unacceptable Urination in Cats

Unacceptable elimination is a common and frustrating feline behavioural complaint and, when expressed as a repetitive and rigid ritual, it may resemble a pattern of compulsive-like elimination. This retrospective case series reviewed medical records from a single veterinary behaviour service (July 2020–July 2025) to describe cats with longstanding unacceptable urination showing caregiver-reported compulsive features (repetitiveness, redundancy, and rigidity) and to compare outcomes between behavioural modification alone (group B) and behavioural modification plus clomipramine (group C). Twenty-one cats met the inclusion criteria (C, n = 11; B, n = 10) after relevant medical causes had been excluded via physical examination and laboratory testing. Baseline characteristics were comparable between groups, including age, sex distribution, and interval between onset of clinical signs and initiation of therapy. Clinical outcome and time to recovery differed markedly: a positive outcome was recorded in 1/10 cats in group B versus 10/11 in group C after 30 days of therapy (first follow-up). Follow-up completion was also consistently higher in group C across all time points. These findings might suggest a pattern of compulsive-like elimination, with the observed response to clomipramine providing further support for this conceptual framework.