Is it always possible to get rid of lameness?

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I’m struggling with Gillie.  He has taken a quite large downturn this week.  We seem to have decent periods of relatively stable and then a sudden change.  I don’t know if this is a new bone fragment or something.
We saw the vet last week and she confirmed it is his elbow that is painful.
He is very painful and limping when he gets up from rest.  It hurts me to watch him so goodness only knows what it feels like.  After a stretch and a warm up there is little more than a tiny head nod when he walks and trots  We are now down to a few 10 minute on lead potters a day when in January he was doing 30 minute off lead with just Metacam every few days.  He is still playing with toys and eating and drinking quite happily.  We have made adjustments in the home, runners, rugs, raised food bowls, ramp up the step to the house.
He is 30kg and he is now on the full dose of Metacam, 250mg Paracetemol twice daily and 200mg Gabapentin twice daily.  He has physio and massage.  My vet isn’t happy for him to swim now due to the strain on the joint.
Should it be possible to get rid of the pain totally?  I know we can go up on the Gabapentin but the vet wants to monitor him on the Paracetamol first as it was only introduced last week.
He is having PRP on the 22nd, I just wonder what is possible.  I’m finding it hard to know what is acceptable and what isn’t.  I could never say he has had enough because in every other way he is his normal self.
I am going to the event at Sussex County Dog Training later this month so hope to understand better then but I’d love any thoughts on this?

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Hi BevD,
I second all that Hannah has said, and one thing with elbows that I always check is whether they have a tendency to dig? You may well have already thought of this, along with your vet and physio. I have had a few patients with elbow issues who settled dramatically once it was identified that they were diggers and this behaviour was redirected.

Take care.
Kind wishes,
Shona

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