Dear Lucy - I pray for you and Squallie every day. You know him best, but I hope something can be done.
In my experience, constipation can take several days to clear. When this issue first came up with my Rosie, she was hospitalized for
4 days. During that time, she received multiple enemas. It was through that process that we learned she responded best to a lactulose and soap enema. I now do these at home. When we do have to do them at home, it sometimes takes multiple attempts over 2 or 3 days. I know you are dealing with more because of the other issues Squallie has. It may be worth a discussion with the vet regarding maximizing lactulose and miralax to soften the stool to make it easier to pass. The other issue is hydration, so when he is seen by the vet, please ask to confirm he is well hydrated as that is very important to keep things moving. I would also add that after a successful enema, you may not see a bowel movement for a few days as things are re-established. When you see the vet tomorrow, you may want to ask that he do an exam and assess the amount of stool present and also comment on how hard it may be.
I hope you will have more quality time with each other.