Periactin is cyproheptadine, which it seems like you are already giving him.
 
You're right-- high doses of steroids can sometimes cause stomach upset. I have not seen it, so had not thought of it.  Pepcid and/or carafate would be what helps with that.  I would start giving him 1/2 pepcid once a day and also put him on  reglan regularly, and also give him fluids.  If it is nausea those should help.  At this point just not having food is probably making him feel sick, and being on a lot of steroids on top of no food might in fact be giving him an ulcer. You could ask your vet about carafate.
 
I know I jump to lymphoma all the time, but that is also what your vet thinks he has, and the fact that he has responded so much to the dex does make it more probable. 
 
I know you are going out of your mind. I have been there, and I ache for you. I just could not bear the thought of you bringing him to the vet to ask for a feeding tube being convinced he is going to make it, and having to deal with the vet acting like you are crazy and recommending pts right away, which is what I fear would happen.
 
Would he really be a nightmare to force-feed? Some cats who hate syringes are ok with  you putting a gob of food on the back of their tongue, and sometimes just getting some food will make them start eating some. Are you offering fancy feast and liver shake and sour cream and deli slices, etc.?
 
I am so sorry the two of you are going through this. 
 
It is true sometimes about the skin.  My cat Buddy after being on steroids for about 3 months for either lymphoma or FIP started scratching where I had put the needle in for fluids and scratched off a big chunk of skin that left a gaping hole that then continued to itch more. we could not get it to heal at all and it stayed like that until he died.  Some cats do get thin skin from months on steroids.  But the steroids are also the only thing that kept him going for 3 months. And it did not happen to any of my others who were on for just as long. I wondered if I gave him an infection or something with a needle, as if it would slip out during fluids I would just put it back in. Now I change the needle.
 
Michelle

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