Can you add Gabapentin?
What about a narcotic, for the days that he is really bad?
Def. add fish oil.
Traumeel works great in people…maybe worth a try.
Topical rubs, such as Surpass?
However, if the OA is really that bad I would consider a tapering dose of steroid instead of an NSAID. Its a little easier on the liver as you can get longer results with pulsing it, but at the same time balancing quality of life. Knowing that to keep him comfortable, the liver is likely to suffer.
Have you had a liver ultrasound or biopsy done to see why the values are high? Sometimes hepatomas and benign liver issues such as vacular hepatopathy can show increased values that don’t change significantly with NSAIDs.