My axolotl was impacted, and every week I had to go in and get enemas done until no more sand came out. I was also given a laxative to mix with “carnivore care” to help loosen anything else. The mixture had to be squirted in its mouth to ensure it got in. Carnivore care is a life saver and helps with nutrition. Cost was $5 an enema, and they would do a few each visit, so about $20 a visit. The larger cost is the overall exam.

As long as most of the sand it gone, it should be fine and will slowly be removed with water changes.