So we have been working with Emma based on the recommendations from the Dr., and are seeing some progress. Not sure how much of it is the medication she is on, but happy to be seeing things slowly improving.
We took a video of her a couple of days ago and although she didn't destroy anything in the house, she cried and cried and howled and howled. Breaks my heart to see her in such distress. But today we took another video of her after leaving her for an hour and she was much better. No crying or howling.
Things also seem to be getting a bit better with her paw. We got her a brace so when we take her for walks we can use it. But we have been taking her swimming a lot (thank god we live close to a clean river). And she is consistently walking on it.
Hopefully we are moving in the right direction.