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When blood plasma proteins are depleted by bleeding and return of the washed red cells (plasmapheresis) the regeneration of new plasma proteins can be controlled at will by diet. The amount and character of protein intake is all important. Liver protein and casein are efficient proteins to promote rapid regeneration of plasma proteins but some vegetable proteins are also efficient. The blood plasma proteins are reduced by plasmapheresis close to the edema level (3.5–4.0 per cent) and kept at this level by suitable exchanges almost daily. The amount of plasma protein removed is credited to the given diet period. A basal ration is used which is poor in vegetable protein (potato) and contains no animal protein. The dog on this ration can be kept in nitrogen balance but can produce only about 2 gm. plasma protein per kilo body weight per week. With liver or casein feeding this production can be increased three- or fourfold. A reserve of protein building material can be demonstrated in the normal dog when its plasma proteins are depleted. In the first 3 weeks of depletion this reserve in excess of the final basal output may amount to 3–20 gm. protein. This may be stored at least in part in the liver. As much as 50 per cent of this reserve may be albumin or albumin producing material. A reversal of the albumin-globulin ratio may be observed on the basal diet alone. The reversal will always follow plasmapheresis with the dog on the basal diet and the total plasma protein output will consist approximately of 2 parts globulin and 1 part albumin. Liver diet will raise the production and output of albumin and bring the ratio back toward normal. Albumin production may actually exceed the globulin output during liver diet periods. The change is less conspicuous with casein but in the same direction.
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