The mystery is solved... Giardia

The exotic vet popped in before I left work and she let me know that the fecal came back positive for Giardia.

He hadn't had any diarrhea, so she said there was nothing to really do about it. This, I know is not 100% true, because I know that chins are often prescribed metronidazole when positive for Giardia. He is going back to work with me for a recheck next week on Monday or so, when I will pester her about getting him on different meds. I'm unsure if the treatment for this varies based on symptoms since I have zero experience with Giardia in chins.

He's been on the following:
Buprenorphine- .05ml finished last dose 3/6/16
Sulfa Trimethoprim- .15ml currently taking
Bene Bac- 2grams total, also finished
Simethicone- a dropper given twice daily, sometimes a few drops during other feedings.

The only symptom had been the weight loss and his lack of appetite(which is now picking up because he is showing some interest in food, but he's not really touching his bottle). I believe he ate about 2-3 grams of food, which is definitely an improvement since he wasn't touching it before. He's also regularly eating alfalfa hay, but he won't touch the timothy. Cheerios and other treats are also taken eagerly.
Everything else(urine, blood, xrays) came back fine so I'm hoping that this is the only issue.
Now for my questions...

Where do I even start?
What is the proper method I should use to sanitize the cage(note - no hoses available)?
Can the ledges or hanging toys be spared?
What method should I use for washing the fleece, tile, bowl, etc...?
Any other information would be awesome... I just want my little dude to get better.

UPDATE:
I cleaned everything and I restricted him to only half of the cage.
Is fleece a better option right now or should I temporarily switch him to loose bedding?

When would it be safe to add new wooden items in with him? I don't want to make new ledges, put them in, only to have to remove and toss them again.

I've been cleaning and wiping down the cage as often as I can.
My vet did not want to prescribe any meds for the giardia, as she said she doesn't think that that's the cause of him not wanting to eat. His poop is fine, aside from being slightly soft from all the alfalfa hay he's eating. Should I keep pushing for meds? I read that chins who have had it are always positive for it, even when it's not flaring up... Does this mean it may not be the reason he's not eating?

We checked his teeth again, and they were fine. X-rays showed no malo, his roots are okay... No spurs either.

He's maintaining weight with what I am feeding him(less than recommended as he only eats 2grams of pellets if I don't force feed as much and I want to encourage him to eat on his own), so that's a good sign. He's bright eyed, acting normally... He's a bit angry that I tore apart his cage but he's acting fine... Just refusing to eat and drink. While he may nibble on pellets sometimes, I haven't noticed him touch the water bottle at all. He's still taking treats and his supplements willingly.

Chins with untreated giardia eat more and lose weight when its silent meaning there is no loose poo. The chinchilla can have giardia living in a healthy chin and when under stress the parasite reproduces. They will stop eating when the antibiotic treatment starts, so that is why the vet does not think its the issue.

He's willingly eating some things, just not his pellets and he's still not drinking water. He will willingly take the Essentials for Life, but that's all. He will eat some Fuzzys Kindom supplement(I forget which one), oats, alfalfa hay(the leafy bits, not the stems), cheerios, rosehips, he's chewing, and his poops look better than they did.

He wasn't really eating more before I noticed the weight loss, if anything it was slightly less. It's like he lost interest in pellets/timothy hay completely.

This entire thing is driving me crazy.

I'm about to get some probiotics since he's not a fan of Lifeline. Since he won't really touch his pellets, I'm mixing it into the Essentials. How often should he get a capsule? I don't want to overdo it and cause an issue on top of whatever this is.

I may have forgot, but has the vet given a appetite stimulant such as Vit B+ or cyproheptadine?

Also, when he eats something tasty, how does he eat?

Video if malo chin after a filing-chins mouth sore-slow eating and chewing

https://www.youtube.com/watch?v=WwApTjMqOrk

Pi$$ed chin who won't eat

https://www.youtube.com/watch?v=GTGxuoaqnAo

Normal chin getting treat he never gets

https://www.youtube.com/watch?v=IjkGZNs0wMo

She had not, but that is definitely something I can inquire about tomorrow.

Here is a video I just made of him chewing. He doesn't seem to be chewing differently than he has in the past. They're not his favorite but whole rosehips is what I had to get him chewing long enough for a decent video.
https://youtu.be/2SR7O12iwZY

That angry chin was cute though Lol.

If his mouth hurt, IMO, he would not even think about a rose hip!

Now I'm really left wondering why he won't eat. Someone suggested beaphar pellets but I haven't had any experience with it. I've tried Oxbow(what I've been giving him), Manna Pro Sho and Manna Pro Pro. All three are brands he has eaten in the past and he doesn't want any of them. The brand of food doesn't explain him not wanting to drink either. ._.

I'm at a loss right now. :/

I would try the appetite stimulant next and also ask about something like pepcid for the digestive tract-maybe he is having some pain there?

Will do, I'll grab her tomorrow before I leave. She is taking a week to go visit her daughter and I'm not positive on when she's leaving. If anything, I can give her a call and go from there. Though, wouldn't he not want to eat anything then?
This is stressing me out. I just want my little guy to be healthy

I know, it sucks when they can't tell you what is wrong, you just have to shot gun it and try things. I am thinking that whatever is wrong with him is equivalent to when a human is not feeling great, you will eat ice cream but not broccoli because the good feeling you get from the ice cream out weights whatever is making you feel bad.

Valid point. I attempted to feed him some lifeline for the probiotic benefits(I bought capsules but I wasn't sure of the dosage), and he's been sour with me ever since. He absolutely hates it so now he's struggling to take his Essentials... I think I've angered him. ._.

I'm running to work tomorrow morning to get some pepcid and cypro, or whatever alternatives she decided to prescribe. She was in surgery all day today so she was unable to get anything written before my shift was over.

When I mentioned it she was definitely willing to give it a try. She's also at a loss because we just don't know what the problem is. :/

Bit of background:

So my vet was waiting for a response from a specialist, but she did give him something to stimulate his appetite in the mean time, as she's off for the rest of the week. I haven't noticed any change in his eating habits though.

He did eat 2g of food last night after not touching his bowl for a few days... He seems to only eat if I cut his night feeding back and wait until the morning to feed him again. He still won't touch his timothy hay and he still willingly nibbles on alfalfa and takes treats. Also haven't noticed him drinking anything.

UPDATE:

Now for the new stuff... He was cleaning himself, as boys do, and I noticed some swelling. Since he's not fond of being handled, I needed a second pair of hands to check for a hair ring. Though the exotic vet is on vacation, there was someone else who works with me that has experience with chins. I brought him in to check for a hair ring.

There was no hair ring, but there was some swelling and he appeared to be a bit dried out. I'm not sure if the swelling is a different issue or if there was a hair ring that he managed to remove himself. His penis also wouldn't go back in for a few hours, which I will attach a picture of. We applied some lube and left him go for a bit. Before I left work, it had gone back in but I'm still going to keep him moisturized for now.

I don't know if this is an issue on it's own, or if this was a result of whatever is causing him to be ill. I know that they can have trouble retracting their penis when they're malnourished or in pain. He did lose a lot of weight but at this point, I'm not sure what the cause is.

The person who helped me made a call to a specialist and they said it sounded like a prolapse. It went back in rather fast though(I read it can take weeks), so I'm unsure if that is the case.

If anyone has any input, that would be great!

Also not sure if this is significant... but I have noticed some hair loss on his right hind leg. It appears a little flaky... Whether that be from the more frequent dustbaths(since handfeeding can get a bit messy).

Attachment didn't work, but here is the photo.

The prolapsed penis is a symptom not a primary issue. Illness and/or pain is usually the cause but dehydration can also cause it. Ironically there was a recent thread here that knickers got into a twist about it and I had asked my mentor about it and she stated she most often saw in in conjunction with giardia.

So do you believe that the Giardia is the main cause of his issues then? He's just had no diarrhea and no appetite. :/

They can have the giardia silent, if this was my chin and after all you have tried I would try a course of antibiotics for the giardia just to eliminate it-I HATE doing something like this if this was my chin but desperate times bring desperate measures.

Which antibiotic would you recommend? I read that people are choosing against flagyl... Is that true or were they just speculating?

I just want him to get better. :/

I use flagyl for dental infections without issues besides the usual antibiotic side effects, any chin can have a reaction to any antibiotic but the alternative on not using one it not a option IMO. Years ago CAchins stated that flagyl was killing chinchillas and the rumor took off, they later retracted the statement due to the inaccurate nature of the findings so no, flagyl is no worse than any other one, I would go with whatever your vet is comfortable with.