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I own a 98 Ram 2500 2wd with the V10, only 78k. It's been dealer serviced and used as a tow-pig until last year when I picked it up. I used it as a DD for a few months, and towed my 6500# 5th wheel 90 miles away for a week of camping. The only repairs I've needed to do were a oil sending unit (leaking), and 02 sensor, and a wiper motor.
What I found:
First, it's thirsty, but I expected that. Unloaded as a DD, it gets about 10 mpg. Towing the 5th wheel 90 miles to Silver Lake, I left it in tow mode and got a little over 8 mpg. Coming home I left it in overdrive and pulled a little over 9 mpg. So much torque down low that I had no problem with tranny searching. It uses the same transmission as the diesel so I believe it's considered pretty bulletproof.
The thing that scares me about the V10 is that Mopar no longer supports it and parts for it are getting quite scarce. From what I've read, the real killer of this engine is either oil pump failure, cam position sensor and crank position sensor. If I recall correctly, noone makes a camshaft position sensor and there's no work-around or substitute part for it. It's been a while since I read up on it but I never felt confident never knowing if a $30 part was going to leave me down for the count. Add to that the fact that I just prefer the GM trucks, and I now have the Ram for sale. If either my 5.7 or 7.4 goes down, I can head to NAPA and get pretty much anything needed to put it back on the road.