I purchased the large because she's about 68 pounds and I didn't want the thing to fall apart when she becomes more accustomed to it and can actually go potty with the wheels on. We are not there yet. My husband put small pool noodles over the metal bars on either side of her. This should help in our summer heat, so she doesn't get burned and help with any rubbing. So far so good.
This came with a comfort sling to use once she's fully accustomed to the wheels. In my pic and video, we have her in the "sports" sling (part that goes under her belly to hold her in a more upright position). They recommend she stays with the sports one until she's truly used to this. It doesn't allow her to be lazy and just lay in the sling... which I can see would make it hard to get them to walk or run in the wheels. Without the sports version holder her up higher, she probably would be a bum and just want me to roll her about.
The sports sling also has a handle on either side you can use at first to help them get used to the wheels. I don't recall the instructions explaining the handles. But we figured that out during her first go in the wheels. I imagine if she didn't always want to zoom in her wheels, the handles would be an easy thing to hold onto when going to a walk. So far this sucker is sturdy and far exceeding my expectations. I wish I had gotten this sooner.