I agree it seems like a lot of meds. When I have tried cutting back on the Carprofen it seems her pain level visibly increases. Esp by evening, she can not seem to get comfortable. She will stretch, move, and moan to finally lay down, just to get up and reposition herself every 15-20 mins. She does not do this when given the full dose of Carprofen, along with the other drugs. I have stopped the Tramadol when the Amantadine was added in. All the things you have mentioned Missy is either still on or has tried except for the PRP, she had tried laser therapy, acupuncture. adequate injections ( for 2 years), fish oil, green lipped mussel and steroid injections. I did have her to a holistic vet that is quite a distance away from me and she has taken her off the Tramadol, but recommended she stay on the all the other pain meds, however added in Ligaplex, Elbophlex and CBD oil.