I really can't have another dog but...
I think that before doing anything drastic I would try another vet. IMO, a vet should not say "I don't know" without following that statement with "But I'll find out".
Without knowing your friend, the dog or the vet I would suggest if she can't find a local vet to give her answers she might want to go to Gainesville. Thankfully, I've never had to make that trip but I know that you will leave there with an answer.
Your friend might also want to look into adaquan.
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 Loving life in the Village of PattyLand
Y'know that part of your brain that tells you "ENOUGH IS ENOUGH!" I think I'm missing it.
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