Lula Bell's gelding is 20 this year.  He has EPM (been treated several times), and this winter it was bad.  Now LB said he's heaving. . . She wanted me to ask what y'all suggest--supplements, treatments, etc.   Any and all things that have worked or things to avoid if they didn't work.  Thanks y'all 

Would not hurt to give another round of meds. As hot as it is mine are all breathing kind of heavy. Make sure the horse is sweating. I have one that doesn't sweat. He gets One AC. I'm not saying that is the best but works for mine. Make sure they are DRINKING enough water. There is a difference between my horse gets enough water he has a pond AND I know my horse drinks enough water because I have to fill his tank morning and night!  Understand?  Also I have to hose mine down several times a day. Hope that helps. This heat is hard on all animals including humans. 

I would treat him again.  Look into Deanna Harrison’s EPM formula.  Also get him on Vit E.  Equine Omega Vit. E is the best I’ve found.  Make sure it’s 10,000 IU. Electrolytes is this hot weather will help also. 

MVP Eclipse PM is getting rave reviews for EPM horses. I know several of my friends have had great success with it. It would be my first go to if I had one with EPM 

Does he have the heave line along the bottom of his belly yet? I would look into a supplement for heaves. Look into MVP or maybe give Krystal a call and see what she would recommen out of T.H.E. supplements.

How does he do when the day starts cooling off? With all this heat I would think its heat related and when it cools off he wont be heaving. Have her cool him off by water hose by cooling his legs off first then work up to his body when hes heaving and see how he does. 

Yes T.H.E. has an EPM supplement and also Vit E.  I give the Vit E to mine and they seem to do well on it.  I also installed a mister attached to one of my fans in the barn.  They haven't yet learned how to stand by it and cool off yet but it is coming.

MVP makes a product called Eclipse PM. It contains Cinchona Bark extract which is used to treat Malaria (also caused by a protozoa) patients . It also has Magnesium, lysine and vit E (and some other things ) to help reduce inflammation and build the immune system. This would be my first choice for a horse his age. 

I haven't seen Kota in awhile because he's at her parent's house in LA.  I'm gonna send her all these replies so she can get on a program quickly.  Thank y'all so much for your help. . . 

We are seeing and hearing of amazing results using Summit Joint Performance.  Summit is Chondroitin Sulfate & sterile water injectable that can help reduce inflammation all over which helps with the symptoms and overall comfort.  If you have any further questions, I'd be happy to get them answered. :) AND it's affordable!

Thanks for all the replies and information--I think she decided to go with the MVP product(s)   

Good choice , if she has any questions about any of MVP products she can always call them, they are real easy to talk to..