In a medium bowl, mix together sausage, breadcrumbs, garlic powder, onion salt, and Italian seasoning. Using your hands, roll sausage into balls about 1-inch in diameter. Set aside in fridge until ready to use.

In a large pot over medium-high heat, melt butter. Add shallot and sauté for 2-3 minutes until soft. Add zucchini and sauté for another 2-3 minutes until softened. Add garlic and cook for 1 minute, stirring frequently.

To the pot, add chicken broth and water. Bring to a boil over high heat. Reduce heat and stir in orzo pasta. Gently pour in sausage meatballs. Cook over medium heat until meatballs are cooked through, about 15 minutes, or until internal temperature reaches 160°F.

Remove from heat and stir in spinach and pesto. Stir until spinach is wilted.

Ladle soup into bowls and serve topped with a generous sprinkle of grated parmesan cheese.