I suggested X-ray of the bladder to confirm it. It could be a bladder tumour but the hardness and crunchiness of the stones would lead to one diagnosis - bladder stone. 

Since I do not have the X-ray machine, I asked her to get it done at another practice.

The other vet recommended a home-based diet to get the bladder stone "dissolved." So, I did not hear from Jenny for some time after the X-ray nor did I attempt to solicit business from her by following up. Sometimes, I do lose cases to the competitor when sending the dog for X-rays. 

2 months later, Jenny phoned me to get surgery done and that was how I cam to know what transpired after the X-rays.

"Stones felt like a figure of 8" Jenny said when she palpated the bladder. "How could such large stones dissolve when the home-cooked food is fed?" 2 months of home-cooked food and no stones dissolved.

Reddish blood, bright and red stained the backside of the Miniature Schnauzer every day.

Jenny's boss had accepted the medical advice of the vet to dissolve the stones using home-cooked food.

But the female dog kept passing blood in the urine. Jenny decided finally to operate. So, I told her that she had a conflict of interest in the sense that she was my ex-nurse and now the other vet had given a separate opinion to the owner who was her boss.

"How in the world can such a large bladder stone disappear?" Jenny was skeptical and must have been very fed up with having to care for this dog as well as being distressed in seeing blood in the urine for so many months. "The dog is still passing blood in the urine everyday!"

The conflicting veterinary advices had postponed the operation by more than two months. What to do now?  It was not a normal situation for any dog to pass blood in the urine every day for so many months. 

Ultimately, it is up to the owner or the care-giver to decide. If this was my dog, I would opt for surgery rather than try medical dissolution of the struvite stones.

An infected bladder over time would lead to infections of the kidneys or death. That would not be good for this dog.

Jenny decided to get the stones removed. It was better late than never as this dog could just die in time to come as the bladder ruptures or the toxins from the bacteria in the bladder spread to the kidneys, liver and other organs.

Follow up:  Feb 4, 2007.
Four months after surgery, the dog was normal despite a delay of more than 10 months of passing blood in the urine before the surgical removal of the bladder stones. 

Now she does not pass blood in the urine. She can control her bladder and does not dribble urine or is incontinent.

She had been on dry food from puppy hood. Home-cooked food was advised to prevent recurrence. Stones were not analysed but the structure of the stones are indicative of struvite bladder stones formed in an alkaline urine environment by urease-producing bacteria.

Follow up: Aug 10, 2008.
Jenny said that there were no urination problems in the Miniature Schnauzer. No prescription diets or regular urine tests for bacteria or stones in the bladder were done on this dog.

The dog ate home-cooked food. In real life, few dogs in Singapore, after removal of the urinary stones get followed up or review.