In a large, nonstick pan heat olive oil. Add garlic and sauté for 30 seconds. Stir in onions and sauté until soft, about 4 minutes. Add red pepper flakes and cook for 30 seconds. Stir in pasta sauce, tomatoes, carrots, vodka, Italian seasoning, and a little black pepper. Cover pan and simmer on low heat, about 25 minutes. Stir occasionally.
Remove cover and stir in milk and cooked sausages. Mix well and continue to cook another 8-10 minutes until heated through.
Create zoodles and add to a large bowl microwave-safe bowl. Spray zoodles with a little olive oil spray. Sprinkle with a little garlic powder, salt, and black pepper. Microwave covered for about 3-4 minutes until zoodles are soft.
To serve: For each serving, add about 2 cups cooked zoodles to a bowl or plate. Top with 1 cup pasta sauce (includes sausages and carrots). Sprinkle with 1 teaspoon Parmesan cheese, if desired.
Store leftover sauce and zoodles in the refrigerator for 3 days. This sauce freezes great!