I am so sorry Pearl is not feeling well. Ear infections can be so frustrating to treat because the pup and the owner are put through hell together. In cases where my patient is resistance to daily treatments and it is putting stress on the human animal bond I will recommend packing the ear with medication for a week and allowing the inflammation and pain to calm down. I will typically use a medication called BNT or TNT. Your vet may have this or may be able to order it for you through the veterinary compounding pharmacy called BCP. The number your vet would need to call to order this is 1-***-***-****.
As far as the arthritis goes there are some other things your can try on top of the regiment she is on now to help her.
Adding in a medication called gabapentin is great for arthritis and nerve pain. The first week a patient is on it there is an adjustment period where they can be a little tired, but after the first week or their bodies adjust to the mediation and their quality of life improves immeasurably.
You can also look in to acupuncture therapy for arthritis. I have seen it do such wonderful things with all of my patients that have arthritis.
If you vet has the cold laser that could also help with the arthritic pain. Those patients come in 2 times a week for this therapy and leave feeling so much better.
You also may consider tapering off the Rimadyl for a bit and using a short course of steroids to help get the ear inflammation cleared up.
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Kind regards ***** ***** you luck,
Dr. Meghan Denney