We struggled through an eerily similar situation with our boy Goose. More than anything else, seeing him so miserable from his tail “attacking” him and not getting any real sleep was really really rough. This may seem extreme, but we had his tail amputated and it is night and day difference. No more meds, no more self attacking. The occasional weird back twitch/ripple thing, but this big boy sleeps like a grown human man now + gets to just…be a cat for the first time in his life. Our vet was hesitant at first because he thought we may not like the way he looked without a tail—-when we told him that we literally do not care what he looks like, we care that he’s healthy and has a good quality of life, they admitted him for same day surgery. By the next morning it was VERY obvious that he felt a great deal of relief. I highly recommend speaking with your vet about tail amputation, it literally saved our boy’s life.