You must talk to the vet that said he would not operate and ask his options. It is a no-no for a dog with a perineal hernia to have a hard stool so we must add softener to maintain a paste-like texture of the poop. If you can't bring him to surgery you will still need to do something to make him feel relieved. If he can't poop you can bring him to a vet clinic if an enema is possible. If he can't urinate you can bring him to vet for bladder tapper. Caring for a dog with perineal hernia requires too much love and strength for the owner. a surgery cannot guarantee the problem is over. Post-surgery cares portrays the big role. if your dog still loves to eat in spite of his ailment, it means he wants to continue living so give him a chance to live.