As an owner of a much loved 10 year old big dog with problems in both back legs your question does throw up a lot of issues. We were advised by our vet that our dog could have an operation on one of his back legs, but it would be a big operation followed by weeks of recovery, which he thought would maybe be too much for him. Plus it would mean travelling about 300 miles and would cost a fortune. If he was a younger dog, we would probably have considered it, but as he is an older boy, and his other leg would probably develop the same problem ( another major op ) we have decided to just treat him with anti inflammatory and pain killing drugs. His breed has an average age expectation of 12 years so he is considered as being elderly. But it is not easy, we are constantly monitoring him for signs he is in pain and we dread the day we have to make 'that' decision. I think it is up to the owner and their vet to decide what treatments or gizmo's they need. I do know some vets will try to 'milk' the situation, but I think the majority of vets have the animals health as their main concern.
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) bit my poor Dad before he got it in its cage and was left with a scar. This talent for the dramatic moment has stayed with me and I am the butt of many family jokes! 
