I returned mine. Firstly, yes it stands for "small to medium sized dogs", but I still wasn't expecting anything so flimsy! It attaches to the headrests with ties, which any dog who wants can easily devour on a long car ride. My pup chewed a lot harder on leashes than those dainty harnesses, so I didn't want to risk it. But I didn't have to because I couldn't even install it because it's supposed to be vertical and essentially blocks the space between the two front seats and if you have a bulky console you can't use it. Bottom line: It could work with a toothless Chihuahua in the right car. I wouldn't trust him with a strong medium sized dog even if I could get him to work in my car.
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