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

Year 2025, Volume: 20 Issue: 2, 104 - 109, 27.08.2025

Gencay Ekinci , İlknur Karaca Bekdik , Emre Tüfekçi , Alfatıh Mohammed Ahmed Abozaıd , Sadullah Uslu , Şevval Özçavuşoğlu , Nazenin Berfin Karaşahin , Zeynep Kekeç , Celil Bendeş , Melis Ay , Önder Düzlü , Alparslan Yıldırım , İhsan Keleş

https://doi.org/10.17094/vetsci.1555729

Abstract

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.

Keywords

Enterobacter cloacae , Pyoderma , Generalized demodicosis , Pug

References

• 1. Ekinci G, Tüfekçi E, Güneş V, Çitil M. Canine demodicosis. In: Sağkan Öztürk A, Öztürk A, eds. Veterinary: Modern Analysis, Finding and Researches. Lyon, France: Livre de Lyon; 2022:31-49.
• 2. Mueller RS, Rosenkrantz W, Bensignor E, et al. Diagnosis and treatment of demodicosis in dogs and cats: Clinical consensus guidelines of the World Association for Veterinary Dermatology. Vet Dermatol. 2020;31:4-e2.
• 3. Kelly PA, McKay JS, Maguire D, et al. A retrospective study of cases of canine demodicosis submitted to a commercial diagnostic laboratory servicing the United Kingdom and Ireland (2017–2018) part2; Aerobic culture and antimicrobial susceptibility results. Res Vet Sci. 2022;153:92-98.
• 4. Grimont F, Grimont PA. The genus enterobacter. Prokaryotes. 2006;6:197-214.
• 5. Keller R, Pedroso MZ, Ritchmann R, et al. Occurrence of virulence-associated properties in Enterobacter cloacae. Infect Immun. 1998;66(2):645-649.
• 6. Halcon LL. Infection. In: Jane Buckle, eds. Clinical aromatherapy essential oils in healthcare. Churchill Livingstone; 2015:130-167.
• 7. Moritz A, Fickenscher Y, Meyer K, Failing K, Weiss DJ. Canine and feline hematology reference values for the ADVIA 120 hematology system. Vet Clin Pathol. 2004;33(1):32-38.
• 8. MSD Veterinary Manual. Accessed November 11, 2024. https://www.msdvetmanual.com/special-subjects/reference-guides/serum-biochemical-analysis-reference-ranges.
• 9. Duangkaew L, Larsuprom L, Anukkul P, et al. A field trial in Thailand of the efficacy of oral fluralaner for the treatment of dogs with generalized demodicosis. Vet Dermatol. 2018;29:208-e74.
• 10. Ekinci G, Tüfekçi E, Güneş V, et al. Antiparasitic drugs used the in treatment of demodicosis in dogs: 2022 literature review. In: Sağkan Öztürk A, Öztürk A, eds. Veterinary: Modern Analysis, Finding and Researches. Lyon, France: Livre de Lyon; 2022;51-92.
• 11. Miller WH, Griffin CE, Campbell KL. Parasitic skin diseases. Muller & Kirk’s Small Animal Dermatology, 7th ed. St. Louis: Saunders. 2013;310-313.
• 12. Beugnet F, Halos L, Larsen D, et al. Efficacy of afoxolaner in dogs with generalized demodicosis. Parasite. 2016;23:14.
• 13. Plant JD, Lund EM, Yang M. A case-control study of the risk factors for canine juvenile-onset generalized demodicosis in the USA. Vet Dermatol. 2011;22:95-99.
• 14. Bowden DG, Outerbridge CA, Kissel MB, et al. Canine demodicosis: A retrospective study of a veterinary hospital population in California, USA (2000–2016). Vet Dermatol. 2018;29:19-e10.
• 15. Cordero AM, Sheinberg-Waisburd G, Romero NC. Early onset canine generalized demodicosis. Vet Dermatol. 2018;29:173.
• 16. Maslakah AU, Kusumarini S. Generalized demodicosis and malasseziosis in a Pug mix dog. JoPS. 2023;7(2):78-85.
• 17. Sudy E. Pyoderma faciale: gram-negative recovery by means of needle aspiration. Cutis. 2002;69:261-264.
• 18. Shumaker AK, Angus JC, Coyner KS, et al. Microbiological and histopathological features of canine acral lick dermatitis. Vet Dermatol. 2008;19:288-98.
• 19. Nocera FP, Ambrosio M, Fiorito F, et al. On gram-positive- and gram-negative-bacteria-associated canine and feline skin infections: a 4-year retrospective study of the university veterinary microbiology diagnostic laboratory of naples, Italy. Animals. 2021;11:1603.
• 20. Rehbein S, De Vos C, Beugnet FC, Carithers DS, Fourie JJ. Efficacy of once-monthly doses of oral afoxolaner and afoxolaner/milbemycin oxime in a well-controlled study for the treatment of canine generalized demodicosis. Open J Vet Med. 2018;8(12):250-265.
• 21. Romero-Núñez C, Guiliana Bautista-Gómez L, Sheinberg G, et al. Efficacy of afoxolaner plus milbemycin oxime in the treatment of canine demodicosis. Intern J Appl Res Vet Med. 2019;17(1):35-41