Hi, fact is with source IP persistence with my setup which is not unusual, VIP Unified Gateway |NS DMZ| -> SF VIP |NS LAN| -> SF servers. You do not load balanced with source IP so it is bad as everything is coming from NS DMZ SNIP.
Then we are tied down to the same SF because the persistence. I am not using the advanced Storefront monitoring (XML) but all it does is to check the services, nothing fancy. And in my case with the SF server full, the services were still up, I use Nagios, service was fine and event logs does show them up. So even with this adv monitor, I'm confident NetScaler would not detect this issue.
In this case I think Citrix is correct, Cookie insert should be used, which is rare I have to agree! 🙂