PRP injections for very advanced elbow arthritis - any experiences?

[shockthemonkey]

My lovely DD - labrador - now has very advanced arthritis in both elbows. She has had three arthroscopies in the past but I am told she is too advanced for a further arthroscopy to be of any help. She has also had one PRP - they only managed to get enough product to do one elbow. She did benefit, but to be honest it was no miracle and it did not last all that long. But given the PRP was less stressful for her, I would consider it again if she may benefit once again.

Thing is now that her elbows are really bad, with one in particular drawing comments from strangers at ten paces away. I'll upload a picture if that helps. New vet where she does her hydrotherapy and laser massages is saying he could do another PRP - he knows her history and has seen all her imagery which includes MRI and xrays. He seems to think she would benefit.

Last resort for much later is steroid injections into the joint - but he says this is for the end stages 😭

My question for now is does anyone have any experience with PRP at this late stage in her condition? She was first diagnosed in 2019. The bump, as I say, on one of the elbows is very prominent.

How old is she?

Thank you for reading. She's coming up to 11 yrs old

Here are some pics...

I also have scans from 2022 which I might be able to put up on here if I can anonymise it all!

The second pic...

Without knowing all the details and not having seen her of course, I'd gently suggest that any further treatment might not be in her best interests.
Mine didn't have PRP but similar and I regret putting her through it immensely.
I think this is what the strangers at 10 paces are really saying too.
Sorry.

Thank you, Boxer. I appreciate your honesty. I also put in a call to her main vet who knows her v v well and who is not proposing PRP possibly because he does not have the facilities.
Does the disease look very advanced to you? 😫

It is always so difficult to make objective decisions when you are so close and love them so much.
I am not a vet, the questions I would be asking are how is she in herself and behaviour wise? Is she limping? In pain? Eager to move about and go for a walk, even just a short sniffy one?
I think a lot would come down to her quality of life and how best to give her quality over quantity.
I am facing this with my girl who is starting arthritis.

You clearly love her very much and she is lucky to have a mum who puts her first ❤

I am a vet and am more interested to hear about her day-to-day symptoms and level of lameness than looking at a bump at her elbow. Which pain meds is she on?

I really don't know sorry, @shockthemonkey
Grrrr raises good questions about her pain meds and day-to-day symptoms.
I am convinced my dog was used as a guinea pig for the vet's research. After she died, they asked if they could publish her results. I declined.
It's such a difficult decision but just try to think really clearly about things because some suggestions may not be in the best interest of your dog. Easier said than done, I know. I hope you find the best outcome for you all whatever that may be.

I would not be worried as such by the lump more by her day to day challenges.

How far can she walk, is she in pain, does she limp, is she eating, is she restless unable to get comfortable etc.

Dogs and humans scans etc may look horrendous but have little impact on the well being and alternatively scans showing minimal damage can cause a lot of issues.

I would be looking at how this affects her day to day and look at painkillers and life style changes first.

Thank you all so much.

She is a happy lady who still takes pleasure in short walks and brings us her toy when she hears us laugh, or when her Daddy comes home in the evening. Otherwise she sleeps a lot but two nights ago for the first time she let out a yelp of pain then went back to sleep.

Her daily meds are Firodyl 125 each morning, gabapentine 300 each evening. Supplements of chondroitin, glucosamine and Megaderm (omegas) daily. Hills joint defense for the last five years.

She has weekly laser massages and weekly balneotherapy which she enjoys and which she seems to benefit from.

Librella injections on the first of each month. Those really pep her up… we never miss a month.

I am watching her carefully for signs that life is no longer any fun.

Thank you again for your thoughts and sorry I went quiet for most of the day.

She will likely benefit from having paracetamol added into her regime if showing signs of pain. Please see the (evidence based) website caninearthritis.co.uk for a comprehensive review of options to help her which you can then discuss with your vet.

Thank you Grrrrr, will do! She already has two heavy meds daily (gabapentine and firodyl) and limps but shows no other signs of distress (other than that one midnight yelp). Paracetamol on top of that would be OK for when she gets worse?

Paracetamol on top of that would be OK for when she gets worse?

That's really a question for your vet

It is often used in arthritic dogs who are already on non-steroidal anti-inflammatories but need extra pain relief. Definitely worth discussing further with your own vet.