Please help, I have a very sick non-eater

Hi, I've used these forums so often but finally decided to break down and make a post because I am just at a complete loss, am giving up hope, and I need help. This is going to be a long post because I want to be as thorough as possible.
I have a black rat snake who is having major problems. We have been to the vet, and I'm beginning to feel like she doesn't know as much as she's led me to believe, and has perhaps only compounded this poor snake's problems. Unfortunately she is the only herp vet in town and came highly recommended.
So first, this snake's history: He was a rescue snake who I have had in my care for a little over a year. He is a 3 year old adult male black rat snake who was severely neglected and malnourished. When I got this snake, he was 4 feet long and 150g. He was literally skin and bones, he looked like a blade and he was too weak to move. He was previously kept in a 5 gallon tank with no heat, on cat litter, fed only live mice, was too weak to strike or restrict prey, so had numerous bite marks all over his head. He also had retained eye caps and a large mass of stuck shed on his tail. Through persistent efforts, I was able to get this snake on what I thought was a road to a healthy and full recovery. I got him eating, I got his skin issues taken care of, and things were going well for the first 6-7 months.

Husbandry: He is currently in a 55gal tank with a large water bowl, multiple hides everywhere, and his substrate is usually forest floor bedding, though I changed it out for paper towels a few weeks ago when things started getting bad for him. He has a heat mat and a heat lamp (it's cold in my house) and a thermostat, and his warm side is consistently at 87-88 degrees. He has been fed frozen/thawed the entire time he has been in my care.

The problem:5 or 6 months ago, he began showing fussiness with food, was skipping more and more meals. He has been refusing meals for 2 months solid now (sporatically before), and the reason I decided to take him to the vet was because he also started dropping weight. He was at 380g at his peak and now he is at 350g. He also has some lumpiness all the way down his body. The vet found two main lumps, one in the middle of his front half, one in the middle of his lower half, and her best guess, after taking x-rays, was that these were impactions. She gave him a series of laxatives (once a week for 3 weeks) and the lumps have not moved or diminished, and all he produced after all that was one small, slimy bowel movement (this was tested for parasites and came back negative). She also gave me instructions to soak him in warm water for 30 minutes a day, every day, to hopefully help loosen the impactions. And she gave me an ointment for his eyes. (She said his eyes has retained spectacles, and I agree that they have never looked quite "right," but every time he sheds, I check the eye caps, and they're always properly shed. So is this even possible?) I had been doing the soaks every day as instructed, and putting the eye ointment on. After 3 weeks of this, the snake began showing additional signs of problems, and here is where I began to think maybe this vet is causing new problems for my snake: He began prematurely shedding in patches, individual scales. All over the place, they're all over my hands every time I handle him. I began to worry this might be caused by too much soaking so I quit soaking him til his next appointment. This is the point when I also removed everything from his tank, cleaned it, and replaced his substrate with paper towels, just to be on the safe side and to monitor him better. When we had our next appointment, I explained this new problem to the vet and told her I was worried about soaking him so much. She said that wouldn't be the problem, and that I should continue doing it. She also prescribed him an antibiotic which I am giving him twice a week via intramuscular injection. He's had 3 injections so far, and as of yet shows no sign of improvement. I have continued to give him a warm soak, but only every 2-3 days. Just tonight I took him out to check on him, and it appears he might now be developing scale rot!! Around his jaw and in a few places on his belly, some of his white scales have a spotty blackish, almost moldy appearance. I can't believe this. I have worked so hard, and I feel like I am failing this snake, and I have no idea whether to put my trust in this vet, or what I should be doing instead. At this point, I don't see any other option, which I guess is why I am here. This animal is miserable, and it is just so damn hard to watch him waste away like this, given his history and all the time and care I have invested in him.
If anyone has any suggestion, advice, encouragement, experience with this sort of thing, anything, I would greatly appreciate it. Thank you.

I should also mention that throughout this entire time, I offer him all sizes of prey, from pinky to adult mouse. I have 4 other snakes of various ages, and basically any time I am feeding one of them, I check to see if he might want to eat first. I cut the mouse to get the scent of blood out, I brain them sometimes, I always spend a great deal of time making the thing dance around for him. I occasionally will just leave a dead mouse outside of the hide he's in, and put a sheet over his tank to give him privacy. I try feeding him in the morning, in the middle of the night, in his tank, in a separate tub. Trust me, I have tried every combination of things to get this guy to eat. None of it works.

And....is it fate or some bizarre coincidence?? I do not know. But an hour after after I post this, this snake is EATING! Right now! Can hardly believe my eyes. I thought, "well, it can't hurt to try...." and laid a hopper at his door, and he has taken it. So strange. Anyway, this certainly doesn't ease my worry about the poor guy overall, but it IS a positive sign I suppose!

It's possible his more recent refusals could have had something to do with the change of seasons. Did his impactions ever lessen? I would consider having a culture done on the dark spots to see if it's fungal. If you decide to stop using paper towel, I would consider switching to aspen. "Forest floor" typically means cypress mulch, which I generally prefer for more tropical animals. The larger shreds of cypress also carry greater risk of impaction if ingested. I like sani-chip, which you can get for very cheap on pet360.com, as it's tiny, soft, and easy to pass if some is eaten. A couple of my adults have accidentally eaten nearly a mouthful of the stuff with no ill effects. Glad to hear he's eating again! Definitely a good sign.

Welcome and congrats on being such a good caregiver to your snake.
It's puzzling that the x-ray wasn't more conclusive. The Vet should of been able to determine whether the lumps were in the throat, stomach and/or intestines or in the body cavity. If the lumps are still there then I would think they are in the body cavity or muscle of the snake.
If the lumps were not in the equation then I would say its just male hormones at play. Loosing 10% of body weight over 4-6 months would not of alarmed me with an adult rat snake that hasn't eaten.
Lumps aside, I would of advised to not try so hard in getting him to eat because your stress causes stress in him. Patience is the key with most snakes that go off feed. If it isn't a health issue and the environment is correct then most adults will just start eating again on their own if they are not being stressed out. My house snake that finally ended a 2 YEAR hunger strike is an extreme proof of that!!
If the eye scales are coming off with each shed then there are no retained spectacles. Dehydration can cause the eyes to look like retained spectacles.
My rat snakes (american and asian) require a steadier 40-60% humidity than my corns or they have bad sheds. Using cypress mulch that is lightly misted daily will help. The overhead heat lamp is causing low humidity along with your house being closed up for the winter. I run a humidifier in the winter in my reptile room. It might be 60-90% humidity outside but in my heated enclosed house it is about 10-15%. Shedding is a hormonal process and bad sheds can be health related but you must have proper humidity either way. I am a fan of aspen and prefer it over cypress as aspen is a softer easier digestible wood but aspen will mold much quicker than cypress.
Good luck with future feedings!

Thank you for your quick responses!
First of all, yes the lumps are still there, if anything they look slightly worse lately, though I don't know if that's just because of his loss of body mass.
That the x-rays were so inconclusive (and that I never even saw them) troubled me too, and was the first instance in which I began to have some doubts about this vet. $100 charge, and she took him into a back room for 30 minutes, and then kind of just came back out shrugging her shoulders and saying "my guess is that we MIGHT be dealing with...blahblahblah."
I would agree that he shows the signs of a dehydrated snake. But it seems strange to me because he's got a huge water bowl (a 9x12 glass baking dish) in one corner and I keep a plastic tablecloth over his lid to help with evaporation. I see him in his water bowl once in awhile, and I see him take drinks pretty often. I also give him a moist hide any time he goes into shed, and up until now he's had a long series of perfect sheds.
A two-year hunger strike - WOW! lol, that's...insane! I didn't bat at an eye at him skipping meals when he was healthier-seeming, but it was this (rapid) plunge of weight (when he's still underweight anyway, still looks very skinny and doesn't have much in the way of "reserves") that triggered my worry/panic. But I WILL say, that through all of this, I have had this lingering suspicion that much of this is just due to his "adult male-ness." He's my only male snake, so, heck, I don't know! But I kept also having a feeling that something was just not right with him, and so I went to the vet just really HOPING that she would put my mind at ease and say these things are fine and normal and no big deal. Instead, she's prescribed this series of various treatments and at this point I am feeling so unsure whether any of this stuff is helping him or hurting him, whether she knows what she's doing or if I'm being pulled through the ringer and shelling out hundreds of dollars when maybe we would have been better off leaving well-enough alone.
Oh and one other kind of big thing that I entirely forgot to mention which also prompted me to take him in: He started rubbing his head a lot. I've never seen him doing it, but he has completely rubbed off the scales above his eyes and most of his snout. I think this is another thing that made the vet think he had retained spectacles.

A pic of his lumps, head and full body might help us make a better guess what's going on. How sure are you of his age?
The face rubbing is characteristic of a stuck shed, retained spectacles or mites.
The lumps are something to be concerned about. Hopefully you can locate another Vet in your area that is more experienced in reptiles.
When I had my pet store I had a Vet who came to my store weekly mainely for my mammals but her specialty was reptiles. Honestly she made more a week from what I paid her than what I earned but it was important to me that EVERY animal whether a puppy, kitten or iguana was looked at before a sale was made. Anytime there was an unexplained death she would perform an autopsy but rarely did she find the cause of death. Reptiles are still a huge learning curve for most Veterinarians. Many vets have their hearts in the right place but just don't have the experience to help which unfortunately costs you money without getting answers.

Thank you, I will get some pics of him next time I take him out, I don't want to do anything to stress him out the day after his meal, so it'll be tomorrow.
I am not very sure of his age, I just realized I said he was 3 but actually I think he's more like 4. I recall the guy I got him from told me he was 3 when I got him, and I've had him a year. But I do not put much stock in anything his previous owner said, given the condition he kept his animals in, so who knows, he might be older than that.
I'll get pictures of him and his lumps, but they are not large protrusions, more like just hard masses you can feel in his body, they feel like they're in the center (as opposed to out on one side), and they each are about 2-3 inches in length.
The face rubbing is very strange because he definitely doesn't have a stuck shed, the retained spectacles are also not a possibility (I double-checked his last shed from a couple months ago - they're there) and both I and the vet have examined him for mites.
So my plan, I guess, is to finish his round of antibiotics and take him back for his next appointment in a couple weeks. If nothing is resolved by then, the vet told me the next course of action will be to take him up to the nearest state university where they have a herp degree program and let them take a look at him. Hoping the price for that is reasonable, I really have no idea what to expect.

Your Vet has been giving you standard advice for passing impactions, soaking, more movement or exercise for the snake, laxatives, and now antibiotics. I commend you for your perseverance and desire to help your snake. This poor guy has gone through hell in his early life. Now that he is eating the impactions may break loose. Don't give up on the soakings. I think I would ask your Vet to send the X-ray of the snake to your veterinary college for their opinion, however, most Vets can tell the difference between an impaction
and a tumor. Good luck, and let us know how he's fairing.