Conditions such as HIT tend to be overlooked as they are not so common as to keep the clinician being acutely aware of them at all times. Early recognition is of paramount importance as you have amply stressed.
It is unfortunate that Warfarin also becomes unsuitable as an alternative in this scenario as its local toxicity (Warfarin-induced skin necrosis) increases. The mechanism of this is unclear. I would be very thankful to get feed- back on this aspect.