It is quite hard to tank as DK actually, since DnD used to bug out a lot, ranging from improper threat generation to not aggroing mobs at all. Seems to be fixed mostly though, but I rarely use it and play around more on rune strike, icy touch, and blood boil when all diseases are up. Their survivability is quite nice, but a few aggro loss is to be expected if you and your tank are not coordinated well enough.
It also sucks that you cannot spam too much abilities before your runes run out, and death&decay is a costly AoE. That's why I only use it once and try to spread disease as fast as I can before I lose aggro. Most of the time I have to improvise and save Plague Strike/Pestillence for later because I need additional rune for another thing, or if I have to plague strike another mob due to low threat
That said, if you can keep everyone in, you can pretty much survive without aid of healer due to Death Strike spam, rune tapping/vampiric embrace/Mark of Blood if you're blood. If you're Unholy and know when to pop those Bone Shield you can also survive without healer. My guildie heals more than other DK due to triple disease, and Wandering Plague enables him to generate threat constantly, allowing him to tank the mobs as long as he has diseases up.
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