I am shocked by this dilemma. Rowan looks like a cute, clean and friendly dog. I think you have to think about Rowan's quality of life in the future (and how long will that future be, 2 or 5 years?). The operation seems to be a good solution but it has a lot of risk. I would try to medicate him daily. If so Rowan will be fine ... I would be happy. It is just an opinion. Kind regards @hetty-rowan
Thank you ... Rowan is a cute, clean and friendly dog. For now my feeling is to go with the medication for a month or two to see if it this can be the solution for him. With his age and the risks for the operation I think it's best to try it first that way. If that doesn't work enough, we can go for the operation ... but first I think we try the medication for him. And hope for the best! Thank you for your opinion.
I hope everything goes well for Rowan and you. If you have improvement, please let us know with a publication.