Purchased for my 50# mix. His snout is similar length/width proportionally to a GSD, so this muzzle in medium fit his snout perfectly. We had to drill in a smaller hole for the strap that goes over the head, but we were able to do this with a nail, hammer, and screwdriver, so no extra cost to us and not terribly difficult. The leather rivets make the muzzle much more fashionable (and therefore--slightly less terrifying) than a standard basket muzzle which is a very, very nice touch, and I think the soft material makes him more comfortable than he is in a plastic or metal basket muzzle.
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