The final diagnosis was inconclusive. I don't have a copy of the necropsy report, but I have to return to the vet with one of my dogs this week, and I'm going to ask her for a copy. Anyway, what I was told was that he had extensive infiltration of scar tissue into his organs, including his heart (which seemed to surprise the vets). His kidneys were so enlarged with nodules that they filled almost his entire abdomen and had completely crushed his digestive tract (the reason he was no longer able to eat or defecate). The vet thought it was probably some final exacerbation in which his kidneys enlarged greatly, crushing his digestive system that killed him, but by then the damage was so extensive his days were numbered anyway. The cytology labs indicated that the nodules were scar tissue formed in response to inflammation. Cause of the inflammation was unknown, but the vets suggested a genetic autoimmune problem, as the extensive nature of the damage indicated the process had likely been ongoing during most of his life.
It breaks my heart to think of how much pain he must have been in and for how long, but his behavior didn't seem to indicate anything wrong. He ate normally and regularly, never regurgitated, defecated normally and regularly, remained active, and never seemed to have the sort of temperament problems you would expect from an animal in discomfort or pain. The only thing we've wondered about all along was that he seemed to stop growing in length at about 38 inches, but that was still within the norm, and his weight was okay (he was a little butterball). After he was initially treated for parasites when I got him, he fecals came back clear, and the vet never noticed anything unusual in him (but we never did the sort of bloodwork that might have shown a response to inflammation because they never seemed to be a reason). I always fed him on crickets, prekilled/frozen mice, and occasionally cooked meat, but one of his previous owners fed him almost exclusively on goldfish (leading me to wonder about parasitic infection). I'd would be very interested to hear if anyone has ever seen anything like this in other monitors, and I know his vet would, too.