A Case of Generalized Demodicosis and Pyoderma Caused by Enterobacter cloacae in a Pug Dog

In this case report, Enterobacter cloacae (E. cloacae) a rare gram-negative bacterium, and generalized demodicosis were evaluated in the etiology of pyoderma in a 7-month-old Pug dog. As a result of parasitological and bacteriological examinations, Demodex canis (D. canis) and a gram-negative bacterium (E. cloacae) were isolated and identified from deep skin scraping and biopsy samples. A combination of afoxolaner and milbemycin oxime (at the recommended dose of 2.5 – 5 mg/kg of afoxolaner and 0.5-1 mg/kg of milbemycin oxime, Nexgard Spectra® Chewables for Dogs 3.5-7.5 kg, Boehringer Ingelheim) was used for miticidal treatment. For antibacterial treatment, a combination of cefazolin (at a dose of 20 mg/kg, IV, twice daily) and benzylpenicillin + dihydrostreptomycin (at a dose of 0.5 mL/5 kg, IM, daily once) was used until the bacterial culture and antibiogram results were available. The dog was taken to his own shelter by the owner. His treatment was followed by the veterinarian and the animal owner there. It was learned that the dog died on the 3rd day after the treatment. In conclusion, clinicians should consider that rare bacteria such as E. cloacae may be present in the etiology of refractory, persistent, generalized demodicosis complicated with pyoderma cases. In order to rule out the resistance problem until the antibiogram results are available, it is important to choose antibiotics that are rarely used in clinical routine, to identify common and less commonly isolated bacteria by performing bacterial culture and antibiogram from time to time, and to reveal the resistance profiles of these bacteria.