About 4 years ago I used the TopLine Enhance (and their Grass Formula pellets) on a very emaciated clydesdale gelding I rescued. It took about 4 months, but had amazing results. I had inquired about the Xtreme, but was told the Enhance would have the same results, just take a little longer (plus it is less expensive than the Xtreme). And since his health was so poor, I did not want to do "too much, too fast". If you can afford it, I would highly recommend it. Good luck!