
I would have gone to the possibility of bladder stones, or as you say, just 'sand'/gravel right now too. This can be identified by inserting a catheter, which might be advised if the poor boy has a full bladder and isn't able to produce a good flow at the moment!! If there is gravel in there, it will be felt when inserting the catheter. With any luck, he might be able to be back flushed, but if not, then it's open him up and flush it all out.
Apart from GDV (Bloat) this is one of the next real emergency situations as far as I'm concerned. We had one who on a walk, clearly wasn't able to pee as he should. He was very poorly and running a fever. I took him straight into my vet who did as above, and then opened him up and found nunerous small bits of gravel, if not an actual large stone yet.