In a large sauce pan, heat avocado oil. Once hot, add onion and saute for about 3 minutes.
Add in turkey sausage (remove casing), and break up into crumbles. Cook until no longer pink.
Add in garlic, italian seasoning, and pepper and saute another minute or two.
Pour in diced tomatoes, chicken stock, balsamic vinegar, and water. Bring to a boil.
Once boiling, add in tortellini. Cook 10 minutes and then add in almond milk and bag of spinach.
Cook an additional 5 minutes and then turn off heat.
Serve with parmesan cheese! Enjoy!