I would guess you need to have the clutch looked at; it is probably slipping. With that many miles, I am guessing it has been adjusted many a time and will need to be R&R. If at all close to being out of adjustment range, I wuold do that.
As for the shudder, etc - it may be related to the clutch, so I would try the clutch stuff first, but I would head off to the closest Fuller shop (probably any decent truck dealer) and have that examined if the clutch stuff doesn't address it.
Retro-fitting anything is a PIA, but the Jake is probably a better deal. I would consider looking at what other work could be done at the same time while they are dinking arund with the heads, and doing it all at once. It boggles my mind that someone would have ordered an OTR truck without a Jake, although I have seen it before. It has never made sense to me.
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