When my vet couldn't get the prednisolone anymore my vet put Patches on Dexamethasone. I haven't seen anyone else here get that as a substitute but it has worked well and he is still taking it. I just buy it from the vet and it is very reasonably priced. It is a much stronger steroid so he is on a very small dose, only .25 mg a day. It comes in .5 mg tablets. I split them and he gets 1/2 tablet a day. They are scored which makes the splitting easy.