Sacrificing Mutagen tokens also trigger that effect as well, as does returning cards to your hand with something like Sneak
Witherbloom Pestilence Specifications Reasons to buy + Commander provides card draw, lifegain, and +1/+1 counters + Meticulous, grindy playstyle + Blows Witherbloom Witchcraft out of the water Reasons to avoid - Sacrificing smartly is a delicate art Witherbloom Pestilence is a Golgari (black-green) deck that focuses on an aristocratic strategy, sacrificing your critters for greater gain
Theres even another Otter later in the article thats perfect for the 99 of the deck
The section about him from MTG Wiki reads " the Codex Vocifera is a centuries-old tome of convoluted mystical knowledge that has become grouchily self-aware
If a creature with persist that has +1/+1 counters on it receives enough -1/-1 counters to cause it to be destroyed by lethal damage or put into its owner's graveyard for having 0 or less toughness, persist won't trigger and the card won't return to the battlefield
She is a fantastic example of top-down design, in that she is a great representation of the spread of vampirism, and the concept of the "Master Vampire" that takes control of the Vampires it has created