Have you enabled "Unmanaged code debugging"?
See this link:
http://social.msdn.microsoft.com/Forums/is/vsdebug/thread/04e1f64a-aea6-4516-b75d-e4cb1ac0f872
Did you upgrade to .NET 4.5? It appears that can cause issues.
Unable to launch SOS.dll using VS 2010
I know in WinDBG you can issue this command:
.loadby sos clr
This causes it to load the sos.dll that is in the same directory as the clr.